How Dairy Affects IBS (and What to Eat Instead)

Dairy is a common IBS trigger food, and here’s why.

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Before getting a diagnosis of irritable bowel syndrome (IBS), many people assume they are simply lactose intolerant. Dairy products are one of the most common trigger foods among people with IBS, and it may be one of the first foods that lead people to wonder if there’s something wrong with them.

In fact, when doctors suspect someone has IBS, they often test for lactose intolerance (using either a blood test or a breath test). After all, both IBS and lactose intolerance can lead to similar symptoms: abdominal pain, diarrhea, and gas.

How Dairy Affects People with IBS

Cow’s milk contains a carbohydrate called lactose. To break down lactose, your body needs an enzyme called lactase. Mammals have lactase during infancy while they drink breast milk, but most mammals eventually stop producing lactase. Kittens, calves, and cubs all eventually wean off their mother’s milk and switch to water.

A small fraction of humans have evolved to continue producing lactase throughout adulthood, making them lactose tolerant. Still, about 65 percent of humans around the world are lactose intolerant, according to the U.S. National Library of Medicine.

Most people with IBS tend to have lower levels of lactase. Without lactase, the gut can’t break down lactose in dairy well. As a result, it enters the large intestine undigested. Then, bacteria will ferment on the lactose, which produces gas.

To make it worse, people with IBS are hypersensitive to any abnormal movement in the gut. This may worsen the already unpleasant symptoms of lactose intolerance, and the digestion may feel even more painful than it should.

What to Eat Instead

Struggling with IBS symptoms after consuming dairy products? Luckily, there are many alternatives in today’s grocery stores. If dairy triggers your IBS, you have lots of ways to deal with it.

1. Navigate the dairy aisle carefully

Don’t bother switching to goat’s milk, camel’s milk, etc. Any milk from a mammal will contain lactose, so you’ll likely experience the same symptoms. However, you might have luck with lactose-free milk. These products have lactase added to them, which helps break down the lactose.

Not everyone sees their symptoms improve with lactose-free milk. Luckily, today’s dairy aisles contain a wide range of dairy alternatives. You can try soy milk, oat milk, rice milk, macadamia milk, flax milk, hemp milk, and more. Each of these has a slightly different flavor and nutritional profile. Some may be great for cooking, some may be good for drinking by the glass, and some may be perfect in your cereal. Experiment to find what works for you.

2. Keep dairy in small amounts

As with all IBS trigger foods, dairy may cause a range of issues. For some, a small amount of dairy may be perfectly tolerable, such as butter on toast. However, others may experience severe stomach issues after any dairy at all. It’s important to understand your own tolerance level (and a symptom diary can help with that).

If you know you can tolerate dairy in small amounts, you might want to do some planning during the day. For example, if you know you are going out for ice cream later that day, it may help to be more vigilant about not having dairy during the other meals of the day. Then, opt for a small amount: a single scoop, a small sundae, etc. Another option is to check out non-dairy options like sorbet or vegan ice cream.

3. Go beyond the dairy aisle to replace milk and cheese

Replacing cow’s milk cheese with vegan cheese is the obvious route, but it’s not the only one. Here are other ways to replace dairy when cooking and baking:

  • In some baked goods, you can replace milk with water or fruit juice
  • You can replace butter in some baked items with applesauce
  • Top tacos and salad with guacamole or sliced avocado instead of shredded cheese (for that luscious fatty texture)
  • Instead of ricotta in savory dishes like lasagna, you can use firm tofu (seasoned with fresh basil, garlic, lemon juice, nutritional yeast, salt, and pepper)
  • You can make a creamy pasta sauce or soup using pureed cauliflower or cashews

Getting Help for Dairy Woes

If you feel like dairy troubles are limiting your diet, talk to a registered dietitian. It’s easier than ever to be dairy-free, but it can still vary based on where you live and your cultural foods. A dietitian can help you navigate those obstacles and help you find the foods that work for you.

Learn more about what to expect at your first visit with a dietitian here.