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Doctor would ask about symptoms and family history, do physical examination and may ask for some basic tests.
Doctor may advice to stop taking milk and its products for some time and see for any change in symptoms.
The physical examination may consist of:
• Assessment for bloating
• Pressing the abdomen to check for pain or tenderness
• Listening to bowel sounds by stethoscope
In case of suspicion he may advise for some specific tests to confirm the diagnosis of lactose intolerance or any other condition that can produce similar complaints. The conditions could be celiac disease, irritable bowel disease, inflammatory bowel disease or small bowel bacterial overgrowth.
The specific tests that could be done to diagnose lactose intolerance are as follows:
• Hydrogen breath test: The person is made to drink a liquid which contain high levels of lactose. After this, the person is asked to breath into a container at regular intervals and the hydrogen in the breath is measured. Normally, only little amount of hydrogen is found in the breath. However, in case of non digestion of the lactose, it is fermented by the bacteria in colon, releasing hydrogen, which is absorbed by the intestines and eventually exhaled in large amounts in the breath. Doctors also assess if there is any worsening of the symptoms during the test which further indicates the diagnosis.
• Lactose tolerance test: The person is made to drink a liquid rich in lactose. Two hours after this a blood tests is done to measure the amount of glucose in the bloodstream. If the blood glucose level doesn’t increase after 2 hours, it suggests incomplete digestion and absorption of the lactose from the intestine.
• Stool acidity test. This test could be done in infants and children who can’t undergo other tests. In case of indigestion of lactose, fermentation of the lactose in colon produces lactic acid and other acids which is detected in the stool sample.
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