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Definition
Lactose intolerance is the inability to digest significant quantities of lactose. Lactose is a sugar found in milk and other dairy products like ice cream,milk shake,chocolate,cheese etc.
People sometimes confuse lactose intolerance with cow as milk intolerance because the symptoms are often the same. However, lactose intolerance and cow’s milk intolerance are not related. Being intolerant to cow as milk is an allergic reaction triggered by the immune system. Lactose intolerance is a problem caused by the digestive system.
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Causes
Lactose intolerance is caused by an inadequate amount of the digestive enzyme lactase. Lactase breaks down the sugar lactose into sugars the blood stream can more easily absorb. Without enough lactase to digest the lactose eaten, lactose ferments in the colon (large intestine) and causes symptoms.Lactose intolerance is caused by a shortage of the enzyme lactase, which is produced by the cells that line the small intestine. Lactase breaks down milk sugar into two simpler forms of sugar called glucose and galactose, which are then absorbed into the bloodstream. Not all people deficient in lactase have the symptoms commonly associated with lactose intolerance, but those who do are said to have lactose intolerance.
Some people are born with the inability to make the enzyme lactase. Others develop the intolerance over time.
Causes of lactose intolerance include:
Some causes of lactose intolerance are well known. Primary lactase deficiency is a condition that develops over time. After about age 2 the body begins to produce less lactase, though most people will not notice symptoms until they are much older.
Secondary lactase deficiency occurs when injury to the small intestine or certain digestive diseases reduce the amount of lactase a person produces. These diseases include celiac disease, inflammatory bowel disease, and Crohn’s disease.
Researchers have identified a genetic link for lactose intolerance. Some people are born with a likelihood of developing primary lactase deficiency because it has been passed to them genetically (inherited from their parents). This discovery may be useful in developing a diagnostic test to identify people with the condition.
Other common causes are:
Aging (lactase decreases as people age)
Gastroenteritis (or infection in the intestinal tract)
Nontropical and tropical sprue
Cystic fibrosis
Ulcerative colitis
Immunoglobulin deficiencies
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Race: Black, Asian, or Native American
Ethnicity: Mediterranean or Jewish
Symptoms:
Symptoms of lactose intolerance generally begin within two hours of consuming milk or other dairy products. The severity of symptoms depends on how much lactase your body produces and how much lactose you eat.
People who do not have enough lactase to digest the amount of lactose they consume may feel very uncomfortable when they digest milk products. Common symptoms, which range from mild to severe, include nausea, cramps, bloating, gas, and diarrhea.. The severity of symptoms depends on many factors, including the amount of lactose a person can tolerate and a person’s age, ethnicity, and digestion rate.
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Symptoms include:
Nausea
Cramping
Bloating
Abdominal rumbling sounds
Gas
Diarrhea
Loose stools
Diagnosis:
Lactose intolerance can be hard to diagnose based on symptoms alone. People sometimes think they suffer from lactose intolerance because they have the symptoms associated with the disorder, not knowing other conditions such as irritable bowel syndrome can cause similar symptoms. A doctor can use tests to diagnose lactose intolerance but may first recommend eliminating cow’s milk from the diet to see if the symptoms go away.
The doctor will ask about your symptoms and medical history and perform a physical exam. Often the doctor will recommend a two-week trial period of eating no milk or milk products. If symptoms subside, you will be asked to consume milk products again. If milk causes symptoms to recur, you will be diagnosed with lactose intolerance.
Your doctor may also order some tests, which may include:
Lactose Tolerance Test measures the amount of glucose (simple sugar that is created from lactose) absorbed two hours after drinking a high-lactose liquid. This tells how well the body is digesting lactose.
Hydrogen Breath Test measures how much hydrogen is exhaled after drinking a high-lactose liquid
Stool Acidity Test (for infants and small children) measures lactic acid in the stool
Biopsy of the Small Intestine removing and testing a sample of tissue to confirm lactase deficiency (only performed in rare cases)
Treatment:
Lactose intolerance is easy to treat. No treatment can improve the body’s ability to produce lactase, but symptoms can be controlled through diet.
Young children and infants with lactase deficiency should not consume lactose-containing formulas or foods until they are able to tolerate lactose digestion. Most older children and adults do not have to avoid lactose completely, but people differ in the amounts and types of foods they can handle. For example, one person may have symptoms after drinking a small glass of milk, while another can drink one glass but not two. Others may be able to manage ice cream and aged cheeses, such as cheddar and Swiss, but not other dairy products. People can also tolerate more lactose by having smaller amounts of it at one time. The level of dietary control needed with lactose intolerance depends on how much lactose a person’s body can handle.
For those who react to very small amounts of lactose or have trouble limiting their intake of foods that contain it, the lactase enzyme is available without a prescription to help people digest foods that contain lactose. The tablets are taken with the first bite of dairy food. Lactase enzyme is also available as a liquid. Adding a few drops of the enzyme makes lactose more digestible for people with lactose intolerance.
Lactose-reduced milk and other products are available at most supermarkets. The milk contains all of the nutrients found in regular milk and remains fresh for about the same length of time, or longer if it is super-pasteurized.
Currently there is no way to increase the body’s production of lactase, so treatment focuses on managing symptoms.
Treatments include:
Dietary Changes And Dietary changes include:
Keep a food diary of what you eat and what the reaction is. Discuss the findings with your doctor or a dietitian.
Make gradual changes to your diet and record the results.
Try eating a smaller portion before giving up on a dairy product. Dairy products made from milk include:
Ice cream
Sherbet
Cream
Butter
Cheese
Yogurt
Aged cheese and yogurt may be easier to tolerate than other dairy products.
Try milk that is modified so it contains less lactose.
Ask a dietitian for help choosing substitutes for dairy products or recommending supplements to ensure that you eat enough calcium.
Non-dairy foods rich in calcium include:
Salmon
Sardines
Oysters
Collard greens
Broccoli
Read product labels because other foods containing lactose include:
Breads
Baked goods
Processed cereals
Instant potatoes and soups
Margarine
Non-kosher lunchmeats
Salad dressings
Candies
Pancake mixes
Frozen dinners
Other words that indicate lactose are:
Whey
Curds
Dry milk solids
Nonfat dry milk
Milk by-products
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Be aware that some medications may contain small amounts of lactose.
Medications
The doctor may recommend lactase enzymes if you can tolerate only small quantities of lactose. The enzyme supplements come in liquid and chewable form. A few drops of the liquid added to milk allowed to sit overnight can decrease the amount of lactose in the milk by 70-90%. Tablets are chewed or swallowed prior to eating foods that contain lactose.
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Prevention
There are no guidelines for preventing lactose intolerance.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.
RESOURCES:
http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/index.htm and
http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=11717
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