Stomach pain after milk, but no lactose intolerance – that’s what’s behind it

Gastrointestinal problems after milk consumption: Lactose intolerance is often suspected - but this is less common than expected.

Gastrointestinal problems after milk consumption: Lactose intolerance is often suspected – but this is not as common as thought. (Source: Thinkstock/Thinkstock by Getty-Images-bilder)
Lactose is only a small part of cow’s milk. Another ingredient is contained in much larger quantities and can also cause symptoms.

If you experience abdominal pain or flatulence after consuming foods and drinks containing cow’s milk , this may indicate lactose intolerance – i.e. an intolerance to milk sugar. But it doesn’t have to. Lactose is not the only ingredient in cow’s milk that people can be sensitive to.

Here you can find out what other causes can be behind the stomach pain after drinking milk.

What is cow’s milk made of?

Untreated cow’s milk consists of around 87 percent water and four percent fat. The rest consists of milk sugar (around five percent), milk protein (around three percent) and minerals such as calcium, potassium and phosphorus compounds (0.8 percent) as well as vitamins and enzymes (0.2 percent).

There are different types of drinking milk that differ in their fat content and the heat treatment process used. Find out more about the production of cow’s milk and the advantages and disadvantages of the different heat treatment processes here .

Lactose intolerance – not as common as thought

If symptoms such as stomach pain occur after consuming dairy products, lactose is not necessarily to blame. A doctor can determine whether you have lactose intolerance or not using a breath or blood test. Self-diagnosis based on subjective health is often inaccurate and not recommended.

The reason: In many cases of alleged lactose intolerance, there are no medically determinable reasons for lactose intolerance. Lactose intolerance is therefore less common than assumed in the population. This is what the National Institute of Health (NIH), a leading health institute in the USA , assumes. But then what is the reason for the complaints?

Abdominal pain after cow’s milk: intolerance to milk protein

Lactose is not the only component of cow’s milk to which humans can develop an intolerance. The milk proteins it contains – primarily the main milk protein casein and the whey proteins ⍺-lactalbumin and β-lactoglobulin – can also trigger this reaction.

If you do not suffer from lactose intolerance, but rather cannot tolerate one or more milk proteins, there could be two reasons behind it:

  • You suffer from an intolerance to milk protein.
  • You suffer from a real milk allergy.

Milk allergy in adults – rare but possible

Reduced-fat dairy products: They can also alleviate the symptoms.  Experts recommend consuming 0.5 liters of reduced-fat milk or other low-fat dairy products (cheese, yoghurt or quark) every day.
Dairy products: Some people are sensitive to the proteins they contain. Gastrointestinal problems can result. (Source: baibaz/getty-images-bilder)

Milk allergy is characterized by involvement of the immune system and usually becomes noticeable in early childhood. In the majority of children, the milk allergy disappears on its own over time. Therefore, milk allergy is rare in adults. The development of a milk allergy in adulthood is extremely rare, but not impossible.

In the case of a milk allergy, the immune system of those affected reacts very quickly and usually to small amounts of (cow’s) milk. It incorrectly recognizes the milk proteins as harmful foreign substances. The result is a defensive reaction in the body, which usually manifests itself in abdominal pain, nausea or diarrhea. Skin symptoms such as itchy hives or swelling are also possible.

If you have a milk allergy, you can have an allergic reaction to both casein and whey proteins. A mixed form is also common. Depending on what applies to you, you may have to avoid different dairy products:

  • All milk proteins : All milk proteins are contained in regular drinking milk, buttermilk, sour milk, yogurt and kefir.
  • Casein: Occurs primarily in cheese and quark . Cream and butter contain less casein, but a reaction is still possible. Casein is not specific to cow’s milk. It is also found in sheep’s milk, goat’s milk and buffalo milk.
  • Whey proteins: They are only found in whey and are specific to cow’s milk. Allergy sufferers can therefore switch to goat or sheep milk.

Casein intolerance causes stomach pain

Since a true milk allergy is rare in adults, the possibility of an intolerance to the milk protein casein is also being discussed in science as a trigger for milk intolerance. The difference to a milk allergy is that the immune system is not involved in the reaction against the milk protein, or at least not to the same extent.

It is believed that a certain form of casein can cause short-term inflammation in the intestines of some people. This makes it harder for the body to break down lactose. The result is the same symptoms as lactose intolerance: abdominal pain, flatulence and diarrhea.Since casein is contained in most cow’s milk products as well as in sheep’s, goat’s and buffalo’s milk, those affected should avoid or at least reduce the consumption of such products. Only whey is casein-free.


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