Lactose vs Gluten Intolerance - Key Differences in Symptoms and Treatment

Understanding the Difference Between Lactose and Gluten Intolerance

Abdominal discomfort after eating certain foods is common. Two of the most well-known food intolerances are lactose intolerance and gluten intolerance. While they share some similarities, there are important differences between lactose intolerance and gluten intolerance related to causes, diagnostic tests, dietary changes, and potential complications.

Lactose Intolerance Overview

Lactose intolerance means your body lacks enough of the enzyme lactase to properly digest lactose, the natural sugar in milk and dairy products. The undigested lactose travels to the colon causing uncomfortable symptoms like:

• Bloating
• Gas
• Abdominal cramps
• Diarrhea

The severity depend on individual tolerance levels and the amount of lactose consumed. Many people with lactose intolerance can handle smaller quantities, especially when consumed along with other foods.

Gluten Intolerance and Celiac Disease

Gluten intolerance involves an abnormal immune response to gluten, a protein found in wheat, barley, and rye. Celiac disease is the most severe form of gluten intolerance. For those with celiac disease, any gluten triggers immune system damage to the small intestine, resulting in poor nutrient absorption and symptoms like:

• Diarrhea, constipation
• Gas, bloating
• Stomach pain, nausea
• Vomiting, heartburn
• Fatigue, joint pain
• Skin rashes, headaches

Non-celiac gluten sensitivity and wheat allergy are also forms of gluten intolerance with varying degree of symptoms.

Key Differences Between Lactose vs Gluten Intolerance

These two common food intolerances have some key differences:

Root Causes

Lactose Intolerance - Lack of lactase enzyme
Gluten Intolerance - Immune system reaction to gluten protein

Diagnosis

Lactose Intolerance - Lactose breath test, stool acidity test
Gluten Intolerance - Blood test for antibodies, biopsy of small intestine

Primary Treatment

Lactose Intolerance - Lactose elimination diet
Gluten Intolerance - Strict 100% gluten-free diet

Effect of Small Amounts

Lactose Intolerance - May be tolerated in small doses
Gluten Intolerance - Even tiny traces trigger immune reaction

Common Substitutions

Lactose Intolerance - Lactose-free milk, coconut milk, almond milk
Gluten Intolerance - Grains like rice, corn, quinoa, millet, buckwheat

Associated Conditions

Lactose Intolerance - May develop temporarily after stomach illness
Gluten Intolerance - Higher likelihood of other autoimmune disorders

Common Myths and Misconceptions

Despite their popularity, there are several myths and misunderstandings when it comes to lactose and gluten intolerance including:

Myth 1: They are food allergies

Fact - Food allergies trigger immune IgE antibody response causing rapid on-set skin reactions, breathing issues, or even anaphylaxis. Lactose and gluten reactions do not involve IgE antibodies or sudden severe threats.

Myth 2: Only kids get them

Fact - Lactose intolerance often emerges in adulthood after naturally declining lactase levels. Gluten issues may develop at any age after infancy when first exposed to gluten-containing grains.

Myth 3: You'll need special products forever

Fact - In lactose intolerance, some can add small dairy portions back in or take lactase pills to aid digestion. For celiac disease, 100% strict avoidance does need to be life-long to prevent intestinal damage.

Myth 4: They're not serious

Fact - While uncomfortable, lactose intolerance itself is not dangerous. But if untreated, celiac disease raises risks for malnutrition, osteoporosis, infertility, and intestinal cancers.

Identifying Gluten-Free and Lactose-Free Foods

Adjusting your diet is key for managing either form of food intolerance. Being able to identify suitable gluten-free or lactose-free products is essential. Here are some helpful tips:

Reading Food Labels

Scan ingredient lists looking for:

• Gluten-free - No wheat, barley, rye or oats (unless certified GF)
• Lactose-free - No milk-based products (milk, yogurt, cheese, cream, etc.)

Also check for statements like:

• "Gluten-free"
• "Dairy-free"
• "Lactose-free"
• "Vegan"

Sticking to Naturally Gluten and Lactose-Free Foods

Focus on eating more unprocessed whole foods like:

• Fruits, vegetables
• Corn, rice, quinoa
• Beans, lentils
• Nuts, seeds
• Gluten-free whole grains
• Hard cheeses if lactose intolerant

Trying Specialty Substitutes

Use specially formulated products like:

• Non-dairy milks
• Lactose-free dairy
• Gluten-free bread, pasta, baked goods

Health Consequences of Cheating

Deciding to "cheat" by consuming problem foods can have consequences. A little bit of trouble food may get through the system with only mild discomfort. But consuming larger quantities frequently can cause:

Lactose Intolerance

• Severe diarrhea, bloating, gas pains
• Nutrient malabsorption
• Dehydration

Gluten Intolerance / Celiac Disease

• Greatly increased risk of intestinal damage and additional autoimmunity
• Higher likelihood of developing cancers of gastrointestinal tract
• Nutrient deficiencies leading to anemia, osteoporosis, infertility issues

Rarely does intentionally consuming a problem food end well. Being consistent with dietary avoidance is important for minimizing short and long term consequences.

Can Food Sensitivities Change Over Time?

In some instances, food intolerances may change or even resolve over the years. This is more common with lactose intolerance. Gluten issues tend to be lifelong conditions.

Potential Changes in Lactose Intolerance

Some lactose intolerant individuals find with time they can:

• Consume aged cheeses which contain less lactose
• Drink small glasses of milk if sipped slowly
• Use lactase enzyme pills to help digest lactose
• Regain lactose tolerance after healing gut infections

Time Course of Gluten Issues

For those with celiac disease or non-celiac gluten sensitivity:

• Gluten antibodies and immune system reactions persist over time
• Intestinal damage can worsen progressively with continued gluten exposure
• Strict 100% life-long gluten avoidance is imperative

Rare instances of false positive celiac tests early in life may later resolve or reduce to more basic gluten sensitivity. But re-exposure needs careful monitoring.

The Bottom Line

Both lactose and gluten intolerance involve adverse reactions to specific food proteins. Lactose intolerance stems from insufficient digestive enzymes while gluten intolerance centers around abnormal immune responses to gluten. Diagnosis, dietary changes, and potential risks all differ substantially between the two conditions.

Identifying the precise type of food sensitivity through medical testing provides the basis for dietary adjustments and symptom relief. Ongoing strict avoidance of the trigger foods helps reduce both short and long term consequences.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.