Milk and milk products should first be introduced in small amounts and gradually increased in amounts as tolerance improves. Some milk and milk products are better tolerated than others by lactose maldigesters. During the manufacturing of cheese, most of the lactose is removed with the whey. In addition, during the ripening or aging of cheese, most of the remaining lactose is converted to lactic acid and other by-products. Lactose-reduced milk and milk products are also available.
Commercial lactase hydrolyzes lactose in milk prior to processing.
Lactase Enzymes Commercial lactase enzymes, in liquid or tablet form, are sold without prescription, as well. The enzyme lactase, produced by starter cultures Streptococcus thermophilus and Lactobacillus bulgaricus used to ferment some milk and milk products, such as yogurt, partially hydrolyzes lactose. But improved lactose digestion is primarily due to autodigestion within the intestine by the microbial enzymes. Because the bacteria are inactivated by very high or low temperatures, pasteurized yogurt and frozen yogurt are less likely than fresh yogurt to improve lactose digestion.