LACTOSE INTOLERANCE

Lactose intolerance means the body cannot easily digest lactose, a type of natural sugar found in milk and dairy products. This may be caused by the lack of lactase produced bythe small intestine.  When undigested lactose passes to the colon, it may lead to lactose malabsorption, which will cause uncomfortable symptoms such as gas, belly pain, and bloating.

Lactose intolerance is common in adults and it runs in the family. It occurs more often in Native Americans and people of Asian, African, and South American descent than among people of European descent.

In rare cases, newborns are lactose-intolerant. Some premature babies have temporary lactose intolerance because they are not yet able to make lactase. After a baby begins to make lactase, the condition typically goes away.

There are four types of lactase deficiency that may lead to lactose intolerance, this include:

  • Primary lactase deficiency. This is the most common type of deficiency that is due to the decreasing production of lactase as one age.
  • Secondary lactase deficiency. This is caused by infection, diseases, or other problems that may injure the small intestine.
  • Developmental lactase deficiency. This occurs in infants born prematurely and lasts for only a short time.
  • Congenital lactase deficiency. This is a rare condition in children wherein the small intestine produces little or no lactase from birth.

Symptoms of lactose intolerance can be mild or severe, depending on how much lactase your body makes. Symptoms usually begin 30 minutes to 2 hours after eating or drinking milk or milk products. If you have lactose intolerance, your symptoms may include:

  • Bloating.
  • Pain or cramps in the lower belly.
  • Gurgling or rumbling sounds in the lower belly.
  • Gas.
  • Loose stools or diarrhea. Sometimes the stools are foamy.
  • Throwing up.

DIAGNOSIS

If your doctor thinks you have lactose intolerance, he or she will ask questions about your medical history and do a physical exam. Before making a diagnosis, your doctor may ask that you avoid dairy products for a short time to see if your symptoms improve. You may also be asked to bring in a sample of your stool. The stool of a person who has lactose intolerance is usually loose or watery. It also can be foamy.

To confirm a diagnosis, your doctor may order a:

  • Elimination diet. If an elimination diet is to be used for diagnosing lactose intolerance, it should be a rigorous diet. Elimination of all milk products should eliminate symptoms completely if lactose intolerance alone is the cause of the symptoms.
  • Milk challenge. A simpler way of diagnosing lactose intolerance than an elimination diet. A person fasts overnight then drinks a glass of milk in the morning. If a person is lactose intolerant, the milk should produce symptoms within several hours of ingestion.
  • Hydrogen breath test. This is the most accurate lactose intolerance test. You will be asked to drink a liquid that contains lactose and then breathe into a machine several times over a couple of hours. If the hydrogen levels in your breath are high, you may have lactose intolerance. This test is not usually done on babies and very young children, because it can cause severe diarrhea.
  • Lactose tolerance test. This test measures your blood sugar after you eat or drink lactose. You will drink a liquid that contains lactose, which may cause gas or pain in your belly. Then your blood will be tested every 30 minutes for 2 hours. If your blood sugar levels do not rise, you may be lactose-intolerant.

 

RECOMMENDED MEDICATIONS

There’s currently no way to boost your body’s production of lactase, but you can usually avoid the discomfort of lactose intolerance by:

Dietary changes

The most obvious means of treating lactose intolerance is by reducing the amount of lactose in the diet. Fortunately, most people who are lactose intolerant can tolerate small or even moderate amounts of lactose. It often takes only elimination of the major milk-containing products to obtain sufficient relief from their symptoms. Thus, it may be necessary to eliminate only milk, yogurt, cottage cheese, and ice cream. Though yogurt contains large amounts of lactose, it often is well-tolerated by lactose intolerant people.

Another means to reduce symptoms of lactose intolerance is to ingest any milk-containing foods during meals. Meals (particularly meals containing fat) reduce the rate at which the stomach empties into the small intestine.

Lactase enzyme

Caplets or tablets of lactase are available to take with milk-containing foods.

Adaptation

Some people find that by slowly increasing the amount of milk or milk-containing products in their diets they are able to tolerate larger amounts of lactose without developing symptoms. This adaptation to increasing amounts of milk is not due to increases in lactase in the intestine. Adaptation probably results from alterations in the bacteria in the colon.

Calcium and vitamin D supplements

It is important for lactose intolerant persons to supplement their diets with calcium. A deficiency of vitamin D also causes disease of the bones and fractures. Milk is fortified with vitamin D and is a major source of vitamin D for many people. Although other sources of vitamin D can substitute for milk, it is a good idea for lactose-intolerant persons to take supplemental vitamin D to prevent vitamin D deficiency.

Related Articles

(FDC)

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Follicular dendritic cell sarcoma (FDC) is a form of sarcoma that [...]

FAMILIAL CONGESTIVE CARDIOMYOPATHY

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Familial congestive cardiomyopathy, also known as familial dilated cardiomyopathy, is a [...]

EWING’S FAMILY OF TUMORS

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Ewing’s family of tumors, otherwise referred to as Ewing sarcomas, is [...]