Lactose intolerance, also called lactase deficiency, is a condition where one cannot digest lactose - a type of natural sugar found in milk and dairy products - due to partial or complete deficiency of lactase. It's usually not dangerous, but symptoms of lactose intolerance, is generally an uncomfortable feeling.
What causes lactose intolerance?
The body digests lactose using a substance called lactase to break down lactose into two sugars called glucose and galactose, which can then be easily absorbed into the bloodstream.
People with lactose intolerance don't produce enough lactase, so lactose stays in the digestive system where it is fermented by bacteria, leading to the production of various gases, which causes the symptom associated with lactose intolerance.
Depending on the underlying reason why the body does not produce enough lactase, lactose intolerance may be temporary or permanent. Most cases that develop in adults are inherited and tend to be life-long, but cases in young children are often caused by an infection in the digestive system and may only last for a few weeks.
Types of Lactase Deficiency:
Four types of lactase deficiency may lead to lactose intolerance:
- Primary lactase deficiency
- Secondary lactase deficiency
- Developmental lactase deficiency
- Congenital lactase deficiency
Symptoms of lactose intolerance:
The common symptoms of lactose intolerance include:
- Abdominal bloating, a feeling of fullness or swelling in the abdomen.
- Abdominal pain or cramps.
- Flatulence (passing gas).
- Nausea and sometimes vomiting.
The symptoms of lactose intolerance usually occur 30 minutes to 2 hours after consuming milk or milk products or after eating or drinking food that contains lactose. Symptoms may range from mild to severe, based on the amount of lactose the person ate or drank and the amount a person can tolerate.
Risk factors for lactose intolerance
- Increasing age - Lactose intolerance is uncommon in young children but may, develop intolerance as one gets older.
- Family history of lactose intolerance.
- Premature birth - Premature infants are more likely to have a lactase deficiency than full-term infants as the enzyme lactase increases in the fetus, late in the third trimester.
- Ethnicity - People of Asian, African, Afro-American, native American, and Mediterranean ethnicity have a higher risk of being lactose intolerant than people from northern and western Europe.
- Certain illness/ cancer treatments - Certain illnesses or conditions that can damage the intestinal tract such as: Gastroenteritis, Celiac disease, Cystic fibrosis, Crohn's disease and chemotherapy increase the risk of lactose intolerance.
Test to help to make diagnosis include:
- Hydrogen breath test: measures the amount of hydrogen in a person’s breath. This test requires the patient to drink a liquid that contains high levels of lactose. The amount of hydrogen in breath is measured at regular intervals. Undigested lactose produces high levels of hydrogen when a person eats or drinks lactose.
- Stool acidity test : Undigested lactose creates lactic acid and other fatty acids that a stool acidity test can detect in a stool sample.
Foods with lactose are:
Lactose is found in milk and milk-based products such as:
- Ice cream
- Cottage cheese
- Milk sugar
Managing lactose intolerance:
- Lactose intolerance is mainly managed with dietary changes. Limiting or eliminating milk from the diet helps to controls the symptoms.
- Many people with lactose intolerance can tolerate some lactose-containing foods by adjusting the type, amount and timing of these foods.
- Add new foods one at a time, decrease the amount, or eliminate the food, if symptoms occur.
- Foods that contain lactose may be better tolerated if they are eaten with a meal.
- Lactose-free, lactose-reduced, and soy milk or rice milk are good substitutes for regular milk.
- Meeting the calcium requirement is necessary for people with lactose intolerance, hence non-dairy foods rich in calcium can be included like fish such as salmon, tuna and sardines, calcium-fortified juices and cereals, green leafy vegetables like spinach, turnip, broccoli, soya bean, tofu, dried beans sesame seeds, almonds.
- People with lactose intolerance are generally more likely to tolerate hard cheeses. This is because yogurt contains active and live bacteria that initially break down the lactose into lactic acid, which is easy on the intestines.
- As per the doctor’s advice individuals can use lactase tablets and drops when they eat or drink milk products. The lactase enzyme digests the lactose in the food and therefore reduces the chances of developing digestive symptoms.
- Read product labels because other foods can contain lactose including:
Breads, baked food, processed cereals, instant potatoes, soups, breakfast drinks, margarine, processed meats, liquid and powder milk-based meal replacements, protein powders and bars, salad dressings, candies, non-dairy coffee creamers and whipped toppings.
- Studies have shown that individuals with lactose intolerance often do not take in enough of vitamin D and calcium hence supplementation under the doctor’s guidance is essential.
- Be aware that certain medications may contain small amounts of lactose.