Lactose intolerance and dairy sensitivity would not cause damage to the villi like gluten does. However, it may cause similar gastrointestinal symptoms, such as gas, bloating and pain. It is very common that people with celiac disease have issues with dairy, either with lactose or the proteins in dairy. Lactose intolerance, is the most common cause for issues with dairy products, especially early on in diagnosis before the intestine heals properly.

In celiac disease, an autoimmune response is triggered when gluten is ingested and causes damage to the lining of the small intestine. Damage to the intestinal lining can lead to the body’s inability to produce an enzyme called lactase. This is the enzyme that breaks down lactose. Lactose is the sugar in milk and dairy products.

When lactose is not broken down by lactase in the small intestine, it gets fermented by bacteria in the large intestine, leading to symptoms such as:

• Excessive gas
• Bloating
• Diarrhea
• Constipation
• Cramps
• Nausea and vomiting

Once a gluten-free diet is followed and the intestine heals properly, a lot of people are able to produce the lactase enzyme that breaks down lactose, and tolerate dairy foods again. However, some stay lactose intolerant. Lactose intolerance is also common in adults because, as we age, the lactase enzyme production is reduced. Lactose intolerance may also vary greatly in severity, with some people being able to still eat small amounts of dairy and others none at all. There is also a supplemental lactase enzyme that can be taken before meals to help digest lactose, although these do not work well for everyone and they would not work for those having issues with proteins in dairy such as those with dairy sensitivity.

Published February 6, 2023.