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Lactose Intolerance

Lactose Intolerance Can Be a Symptom of Celiac Disease


Updated June 03, 2014

Lactose intolerance is very common in people with celiac disease, but lactose intolerance in celiac disease often improves after patients have been on a gluten-free diet for awhile.

Lactose is a type of sugar that is present in milk. Many people are lactose intolerant, meaning they are unable to digest significant amounts of lactose. As a result, they feel very uncomfortable after consuming dairy products, with symptoms that can include nausea, cramps, bloating, gas, and diarrhea.

The underlying cause of lactose intolerance is a shortage of an enzyme called lactase. Lactase is produced in the cells that line the mucosa, or inner surface, of the small intestine. Normally, the body uses lactase to digest lactose in the small intestine, so it can then be absorbed into the bloodstream. People with lactose intolerance can take over-the-counter lactase supplements to prevent unpleasant symptoms after drinking milk or eating dairy products.

Some people are lactose intolerant because they have inherited a genetic predisposition to develop a shortage of lactase. Others, however, develop lactose intolerance due to injury to the small intestine. Untreated celiac disease (that is, disease not being treated with the gluten-free diet) produces a chronic inflammation of the small intestine mucosa, injuring the cells that ordinarily produce lactase.

Several studies have shown that untreated celiac patients have high rates of lactose intolerance. As their intestines heal on the gluten-free diet, however, their lactase-producing cells begin to function again and their tolerance for lactose-containing foods improves. In fact, some researchers recommend that patients who are lactose intolerant when they are first diagnosed with celiac disease should be retested for the condition after they’ve been gluten-free for a year. The gluten-free diet may have helped improve their lactase production to the point where they no longer need to avoid dairy products.


Ojetti V, Gabrielli M, Migneco A, Lauritano C, Zocco MA, Scarpellini E, Nista EC, Gasbarrini G, Gasbarrini A. Regression of lactose malabsorption in coeliac patients after receiving a gluten-free diet. Scandinavian Journal of Gastroenterology 2007; 5 :1-4.

National Digestive Diseases Information Clearinghouse (NIDDIC). A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

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