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Lactose? In My Digestive Tract?

Steven T Prichard
Photo by Sebastian Coman Photography on Unsplash

Milkshakes are objectively delicious. And so simple too; milk, ice cream, severe abdominal pain, bloating, the grumpy dumpies. Those last three ingredients aren’t actually part of the milkshake, but if you have lactose intolerance you can’t have a milkshake without a bit of suffering involved.

While I sat in the fetal position waiting for my brain to tell me to go to the bathroom for the third time in an hour I remembered that I am a scholar. Explaining the terrible details of lactose intolerance is my scholarly duty. Pun intended.

Photo by Eiliv-Sonas Aceron on Unsplash

Lactose is a sugar molecule found in animal milk. Most forms of sugar are broken down and absorbed directly into your small intestine by different enzymes that your body produces. The enzyme that absorbs lactose is called lactase. A newborn baby’s nutrition need is almost exclusively milk based, and their bodies compensate by producing a lot of lactase under normal circumstances. Adults aren’t expected to survive on milk alone (despite the fact that many people scrape by on just cheese and ice cream when they move out on their own), and as a result their bodies produce less and less lactase as they get older.

Over 10,000 years ago, a mutation occurred that gave some people the ability to produce lactase throughout their adult life. Even though it’s been around for thousands of years, the mutation still isn’t very common. It’s most prevalent in people of European heritage due to the fact that their ancestors were more likely to consume dairy. That didn’t stop other mutations from occurring in other parts of the world though. Even in India, where dairy consumption is relatively uncommon, a different mutation developed that allowed lactase persistence.

From an evolutionary standpoint, a mutation like this is fascinating. Since the mutation came about around the same time humans started raising farm animals, it shows that humans can evolve in direct relation to a symbiotic relationship. This on its own is amazing, but since raising animals is a cultural trait, it also points to the evolutionary ability for humans to evolve through cultural changes.

As cool as it is that some people have lactase persistence, it unfortunately doesn’t always matter. Some people who are lactase nonpersistent don’t show symptoms of lactose intolerance, even though some people who are lactase persistent do show symptoms. What gives? Well, everybody is different, and some people just aren’t lucky enough to eat as much cheese as they want. Unfortunately it seems that everybody is intolerant to lactose after some limit is hit.

Photo by Fatima Akram on Unsplash

Around 65% of the world experiences discomfort when digesting lactose and I’m willing to bet the other 35% just never hit their limit. The argument can easily be made that everybody is lactose intolerant to some degree, it’s just that some people will feel the discomfort after a glass of milk where others could drink a gallon before they feel uncomfortable.

Lactose isn’t really the culprit here though, it’s a lack of lactase. If you’re short on lactase then lactose is going to ruin your day once it gets into your colon. Bacteria breaks down sugar causing it to ferment and release gasses like carbon dioxide. If this were happening outside of the body it would hardly be noticeable, but inside your body there isn’t anywhere for the gasses to escape which causes bloating and pain since your insides are expanding where there’s nowhere to expand. Well there is one way for the gasses to escape at that point, and the mom-approved terms for what that is called include toots, stinkers, or trouser coughs. Cool moms will just call it a fart, and science moms will call it flatulence.

Also, since your body is trained to react to discomfort as it would a threat on your life, your brain orders your bowels to flush everything out with water. Watery bowels lead to probably the worst symptom of lactose intolerance that also goes by many names: the grumpy dumpies, the squirts, fudge puddles, or diarrhea.

So what do you do about lacking lactase? If you’re a bit of an idiot like me, you just get over it with clenched teeth and the occasional tears, but there are significantly better options in dealing with lactose intolerance. There are lactase supplements like Lactaid, as well as dairy products infused with lactase to help reduce symptoms. We also live in the future now so we can make “milk” out of all kinds of things like soy and almonds. And this isn’t limited to just milk, there’s plenty of non-dairy replacements for things like ice cream made from coconuts, or coffee creamer made from vegetable oil. Of course, there’s always the option of abstaining from dairy entirely, which I like to call “The American Sex Ed Approach," but that just makes people want it more.

Original author: Steven T Prichard
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