Ep 58: Lactose Intolerance After Bariatric Surgery
This post is a companion to Episode 58 of the Bariatric Nutrition Coach Podcast. Listen to the full episode on Spotify or Apple Podcasts.
Lactose intolerance after bariatric surgery is more common than most people expect — and if you didn't have any issues with dairy before surgery, it can come as a complete surprise. Here's what you need to know.
What Is It and Why Does It Happen?
Lactose is the sugar naturally present in dairy foods. To digest it, your body needs an enzyme called lactase. After bariatric surgery — particularly bypass procedures — lactase production can temporarily drop, making it harder to tolerate foods containing lactose. Symptoms include bloating, gas, abdominal pain, and loose bowels.
Is It Permanent?
For most people, no. I like to say people "grow out of it" — by around six months post-surgery, most people find their tolerance has significantly improved or completely resolved. Think of your gut like a bucket: early on, it's very small and even a little lactose overflows into symptoms. Over time, the bucket gets bigger and you can tolerate more.
What Can You Tolerate in the Meantime?
The more processed a dairy food is, the less lactose it contains. Hard cheeses (like cheddar) have very little lactose and are usually well tolerated. Some yoghurts are also fine in smaller amounts. Milk — and anything made with significant quantities of milk — tends to cause the most trouble and may need to be avoided or swapped out temporarily.
What to Use Instead of Dairy Milk
If milk isn't working for you right now, look for a plant-based milk that provides at least 300mg of calcium and at least 8g of protein per 250ml. Many almond and rice milks don't meet this bar without fortification — soy milk is more likely to, but check the label. And yes — even if you're getting good dairy intake, please keep taking your calcium supplement after surgery. Your absorption has changed.
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