**Figure 1.** Intolerance symptoms are caused by the osmotic effect of lactose on the intestinal lumen and by the fermentation effect of colonic bacteria that produce gases, such as hydrogen, carbon dioxide, and methane (H2, CO2, and CH4), acid and harmful metabolites. H2: hydrogen; CO2: carbon dioxide; SCFA: short-chain fatty acids. Source: Developed by the authors.

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Pathophysiology of lactose intolerance illustrating how undigested lactose causes symptoms through osmotic effects in the intestinal lumen and bacterial fermentation producing hydrogen, carbon dioxide, and methane gases.

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Diagnostic algorithm or classification scheme for lactose intolerance, distinguishing between primary (genetic), secondary (disease-related), and congenital forms of lactase deficiency.

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Lactose intolerance: myths and facts. An update.

Archivos argentinos de pediatria (2022)

PMID: 35068123

DOI: 10.5546/aap.2022.eng.59

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![Figure 1: Pathophysiology of lactose intolerance illustrating how undigested lactose causes symptoms through osmotic effects in the intestinal lumen and bacterial fermentation producing hydrogen, carbon dioxide, and methane gases.](https://pdfs.citedhealth.com/figures/35068123/104.png)

> Source: M Del Carmen Toca et al. "Lactose intolerance: myths and facts. An update.." *Archivos argentinos de pediatria*, 2022. PMID: [35068123](https://pubmed.ncbi.nlm.nih.gov/35068123/)

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  <img src="https://pdfs.citedhealth.com/figures/35068123/104.png" alt="Pathophysiology of lactose intolerance illustrating how undigested lactose causes symptoms through osmotic effects in the intestinal lumen and bacterial fermentation producing hydrogen, carbon dioxide, and methane gases." />
  <figcaption>Figure 1. Pathophysiology of lactose intolerance illustrating how undigested lactose causes symptoms through osmotic effects in the intestinal lumen and bacterial fermentation producing hydrogen, carbon dioxide, and methane gases.<br>  Source: M Del Carmen Toca et al. "Lactose intolerance: myths and facts. An update.." <em>Archivos argentinos de pediatria</em>, 2022. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35068123/">35068123</a></figcaption>
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