It is important to differentiate between a true milk allergy from lactose intolerance. The former involves the immune system reacting to specific milk proteins, typically casein, and the latter is secondary to digestive inability to breakdown lactose or milk sugar.

A true milk allergy might cause immediate symptoms after consumption such as:

1. Hives
2. Wheezing
3. Vomiting
4. Anaphylaxis, although rare, this reaction is serious (airway constriction, severe drop in blood pressure, flushing of the skin) and requires immediate medical attention.

Delayed milk allergy symptoms might include the following:

1. Runny and itchy nose
2. Watery and itchy eyes
3. Coughing
3. Skin flushing
4. Abdominal cramps
5. Diarrhea (colic in babies)

On the other hand, lactose intolerance causes irritable bowel syndrome (IBS), producing digestive symptoms shortly after consumption such as:

1. Bloating
2. Gas
3. Abdominal cramps
4. Diarrhea

As you can see, these digestive symptoms are similar to delayed milk allergy symptoms and this can cause some confusion. However, lactose intolerance only produces irritable bowel symptoms as described.

Here is something else to consider, irritable bowel syndrome or IBS is not the same as inflammatory bowel disease or IBD. Confused? The latter in this case, is an inflammatory condition of the colon (ulcerative colitis) or of the small intestine and colon referred to as Crohn's disease. Differentiated by location, both are considered autoimmune conditions with various dietary triggers, and cause similar symptoms such as bloating, gas, abdominal cramps and diarrhea (severe) leading to malabsorption and malnutrition. Although IBD does cause other symptoms, it does have similar digestive symptoms as milk allergies and IBS.

Then you have celiac disease, an autoimmune reaction to gliadin, a protein found in gluten (wheat, barley and rye). And you guessed it, celiac disease also causes similar digestive symptoms as well as other systemic symptoms.

Finally, soy proteins also cause allergic reactions very similar to milk proteins, and in fact, is more common than milk allergies. It is very important to understand the difference between milk and soy proteins, and how they effect us, including infants and children. This is a topic that I devote great time to in my book and is worth learning about.

So, the key is how to differentiate and then how to treat? Of course treatment will vary based on the condition and is too involved to discuss in this post. However, aside from allergy blood tests, there is another test that I use in my practice to help differentiate gastrointestinal conditions: the Comprehensive Digestive Stool Analysis (CDSA 2.0) by Genova Diagnostics. This is an easy test to perform at home over a three day period.

For more information about this test, please email me via my contact page.

Dr. Sardone