When a scoop of ice cream causes more stomach pain than personal pleasure, is it lactose intolerance or irritable bowel syndrome? Here’s how to tell.

Hmmm. Was it the sour cream or the nachos?

If you suffer from an upset stomach after eating food combos such as this, it could be due to irritable bowel syndrome or lactose intolerance. But distinguishing which condition is the culprit, or if it’s both, can be tricky.

This month is the right time to learn the difference. April is IBS Awareness Month, dedicated to better understanding of a condition – irritable bowel syndrome – that troubles an estimated 50 million Americans.

And because many people might mistake IBS for lactose intolerance, and vice versa, it’s also an opportune time to learn more about lactose intolerance, which affects nearly seven in 10 people worldwide.

If you or someone you know exhibits some of the telltale signs of a gastrointestinal (GI) disorder, such as lactose intolerance and/or irritable bowel syndrome (IBS), the following descriptions and symptoms can help you determine your next best steps, including treatment options.

Separating the Causes of Lactose Intolerance and IBS

Many people understand the basic signs of lactose intolerance and IBS, such as gastrointestinal discomfort and irregular bowel movements, but they may not be so sure of the causes. This can make it easy to misinterpret one for the other.

So, let’s cover what each condition is:

Lactose intolerance is the inability to digest lactose, a natural sugar in dairy products. This disorder stems from a lack of the enzyme lactase, which breaks lactose down into simple sugars the body can absorb. Lactose intolerance can potentially lead to calcium and vitamin D deficiencies. Risk factors include race: In the U.S., African Americans, Asian Americans, Hispanics/Latinos, and Native Americans are more prone than whites to lactose malabsorption. Other GI conditions, including the gluten-triggered autoimmune disorder celiac disease, can contribute to lactose intolerance. Inflammatory bowel disease (IBD) also poses a risk.

Key symptoms of lactose intolerance, which typically occur 30 minutes to two hours after consuming dairy, include:

• • Diarrhea
  • Gas and abdominal bloating
  • Stomach cramps and pain
  • Nausea and vomiting

IBS is when food moves too quickly or too slowly through the lower digestive tract. Researchers believe this can be caused by a miscommunication between the brain and the gut (). Risk factors include family members with IBS, a history of stress, gender (women are more prone than men), and a severe digestive tract infection. If you experience abdominal pain that affects your bowels at least once a week for three months, you could have IBS. Fortunately, IBS does not develop into serious conditions such as IBD, but it can cause anxiety and threaten your quality of life.

IBS symptoms include:

• • Constipation and/or diarrhea
  • Gas and abdominal bloating
  • Cramping and pain
  • Sense of pain relief – or worsening pain – from going to the bathroom
  • White mucus in the stool

You Can Have Both, But They Are Not Linked

You can see the symptoms of lactose intolerance and IBS overlap, yet the two conditions are unrelated due to their causes. Many types of foods (including dairy) can trigger IBS, while only dairy products prompt symptoms of lactose intolerance. Someone with IBS might experience discomfort from eating dairy but isn’t necessarily intolerant to lactose.

Yet, it is possible to have both IBS and lactose intolerance. This is partly owing to each condition’s prevalence: 36% of Americans live with lactose intolerance and up to 15% with IBS, according to the National Institutes of Health and the American College of Gastroenterology.

Researchers, however, have not conclusively linked the two conditions.

How to Ease the Discomfort of Lactose Intolerance and IBS

The obvious remedy for both lactose intolerance and IBS is avoidance. Knowing which foods to steer clear of, however, takes some detective work. You can help by keeping a food journal of what and when you eat to identify “trigger” foods.

A gastroenterologist can then diagnose the specific cause of your gastro discomfort and determine the proper treatment. Tests include blood and stool screenings, breath tests, and possible internal screenings such as an upper endoscopy, an outpatient procedure in which a tiny camera is threaded into your GI tract through your esophagus (food pipe) to view the lining.

If you are diagnosed with either lactose intolerance or IBS, your treatment approaches will be similar:

• Diet modifications – The foods you eat do not cause IBS or lactose intolerance, but certain food categories can aggravate the symptoms. These include (for IBS) dairy, fatty foods, spicy foods, and gluten. Your food diary will help narrow down these trigger foods. If you avoid dairy and your symptoms ease, but then return once you consume dairy again, you are likely lactose intolerant. If your doctor diagnoses IBS, eat more fiber, exercise, and try to reduce stress while eliminating trigger foods. Also, that eliminates certain sugars you might have trouble digesting.
• Medications – Lactose intolerance may be eased with lactase enzyme supplements that could reduce the chances of symptoms if you do eat dairy. IBS medications include prescription drugs designed specifically for IBS, antidepressants to relieve pain, and probiotics to support digestion.

The takeaway is that you can take irritable bowel syndrome out of lactose intolerance, but you can’t always take lactose intolerance out of IBS. You can, however, take control of the causes of each.

This April, share the word with friends and family members who suffer from gastrointestinal issues. It could be IBS and/or lactose intolerance, and you can eat your way out of it.

You can access more resources about irritable bowel syndrome, including IBS support groups, on our IBS web page, and read our blog that provides six helpful tips for living with IBS. To contact a specialist to discuss your digestive issues, simply request an appointment here.