Lactose intolerance refers to a medical condition in which an individual experiences difficulty in digesting lactose, a natural sugar present in dairy products and milk. This occurs when the body does not produce enough lactase, an enzyme that is responsible for breaking down lactose into glucose and galactose for absorption into the bloodstream.
Types of lactose intolerance
There are three main types of lactose intolerance, which we will discuss below.
Primary Lactose Intolerance
The most prevalent form of lactose intolerance is referred to as primary lactose intolerance. It occurs when the body does not produce enough lactase, the enzyme responsible for breaking down lactose. This type of lactose intolerance is usually hereditary and develops in adolescence or adulthood. Primary lactose intolerance is more prevalent in certain ethnic groups, such as Asians, African Americans, and Native Americans.
Secondary Lactose Intolerance
Secondary lactose intolerance occurs when lactase production is reduced due to an underlying condition or injury to the small intestine. Conditions that can cause secondary lactose intolerance include celiac disease, Crohn's disease, and bacterial overgrowth in the small intestine. Injuries to the small intestine, such as surgery or radiation therapy, can also cause secondary lactose intolerance.
Congenital Lactose Intolerance
Congenital lactose intolerance is a rare, genetic condition that occurs when a baby is born without the ability to produce lactase. This type of lactose intolerance is present from birth and is usually diagnosed within a few days or weeks of birth. Congenital lactose intolerance is very rare and only affects a small number of infants.
It is essential to note that lactose intolerance is not the same as a milk allergy. A milk allergy is an immune response to milk proteins, whereas lactose intolerance is the inability to digest lactose. The symptoms of a milk allergy can be severe and life-threatening, while the symptoms of lactose intolerance are usually mild and can be managed with dietary changes.
Signs and symptoms of lactose intolerance
The undigested lactose travels through the digestive system, causing various symptoms. Here, we will discuss the signs and symptoms of lactose intolerance.
Bloating and Gas
One of the most common symptoms of lactose intolerance is bloating and gas. When lactose is not properly broken down, it ferments in the large intestine, causing gas to build up, leading to abdominal bloating, discomfort, and pain.
Diarrhea
Diarrhea is another common symptom of lactose intolerance. The unabsorbed lactose draws water into the colon, leading to loose, watery stools.
Nausea and Vomiting
Nausea and vomiting may occur in individuals who are lactose intolerant. When lactose remains undigested, it can cause irritation to the lining of the stomach, leading to various symptoms of lactose intolerance.
Abdominal Pain and Cramps
Abdominal pain and cramps are common symptoms of lactose intolerance. These may range from mild discomfort to severe pain.
Constipation
While diarrhea is a common symptom of lactose intolerance, some individuals may experience constipation instead. This occurs when the undigested lactose slows down the movement of stool through the digestive tract.
Headaches
In some cases, lactose intolerance can lead to headaches. The reason for this is not clear, but it may be due to the inflammation caused by undigested lactose in the gut.
Fatigue
Fatigue is another symptom that may occur in individuals with lactose intolerance. This is due to the inflammation caused by undigested lactose, which can lead to a general feeling of tiredness.
Skin Problems
In rare cases, lactose intolerance may cause skin problems such as eczema and acne. This is thought to be due to the inflammation caused by undigested lactose in the body.
Anemia
Anemia is a medical condition characterized by an insufficient number of red blood cells in the body. In some cases, lactose intolerance may lead to anemia due to the malabsorption of nutrients caused by undigested lactose.
Weight Loss
Weight loss is a rare symptom of lactose intolerance. This occurs when the individual avoids dairy products altogether, leading to a decrease in calorie intake.
The signs and symptoms of lactose intolerance may vary from person to person. However, if you experience any of the symptoms mentioned above after consuming dairy products, you may have lactose intolerance. It is essential to consult a healthcare professional to confirm the diagnosis and receive appropriate treatment.
Causes of lactose intolerance
Hereditary
Genetic inheritance is the leading cause of lactose intolerance. Primary lactose intolerance is a genetic condition where the body produces less lactase as a person ages. The prevalence of primary lactose intolerance varies among different ethnic groups. For example, in East Asian countries, up to 90% of the population is affected, while in Northern European countries, the prevalence is around 5%.
Gastrointestinal Conditions
Secondary lactose intolerance can occur as a result of gastrointestinal conditions such as celiac disease, inflammatory bowel disease, or bacterial overgrowth in the small intestine. These conditions can damage the lining of the small intestine, where lactase is produced, leading to a decrease in lactase production and subsequent lactose intolerance.
Injury to the Small Intestine
Injury to the small intestine, such as from surgery, radiation therapy, or chemotherapy, can also lead to lactose intolerance. This occurs when the cells that produce lactase are damaged or destroyed, leading to a decrease in lactase production.
Premature Birth
Premature babies may be born with a deficiency in lactase production, leading to lactose intolerance. This is because lactase production in the small intestine only begins in the third trimester of pregnancy.
Medications
Some medications can interfere with lactase production, leading to lactose intolerance. For example, antibiotics can disrupt the balance of bacteria in the gut, leading to a decrease in lactase production.
Methods used to diagnose lactose intolerance
Medical History
A healthcare professional will take a detailed medical history, including any symptoms that you may be experiencing. They may also ask about your family history of lactose intolerance, as this condition can be hereditary.
Lactose Tolerance Test
The lactose tolerance test is a widely used diagnostic method for identifying lactose intolerance. In this test, you will be asked to drink a liquid containing lactose. Your healthcare professional will then measure the amount of glucose in your blood at regular intervals over a period of two hours. If your body is unable to digest lactose, the lactose will remain in your digestive system, and your body will not produce glucose.
Hydrogen Breath Test
Another common method used to diagnose lactose intolerance is the hydrogen breath test. In this test, you will be asked to drink a liquid containing lactose. Your healthcare professional will then measure the amount of hydrogen in your breath at regular intervals over a period of two to three hours. If your body is unable to digest lactose, the lactose will ferment in your digestive system, producing hydrogen gas that can be detected in your breath.
Stool Acidity Test
The stool acidity test is a method used to diagnose lactose intolerance in infants and young children. In this test, a small amount of lactose is added to the child's diet. The child's stool is then tested for acidity. If lactose is not being digested properly, it will ferment in the colon, producing lactic acid and other fatty acids that can be detected in the stool.
Treatment of lactose intolerance
While there is no cure for lactose intolerance, there are several treatment options available to manage the symptoms.
Lactase Supplements
Lactase supplements are available in the form of tablets, capsules, and drops. These supplements contain the lactase enzyme that is needed to break down lactose in the digestive system. They are usually taken with meals or dairy products to help the body digest lactose more effectively.
Lactose-Free Diet
A lactose-free diet involves avoiding all dairy products and foods that contain lactose. This can be a challenging diet to follow, as lactose is found in many processed foods, medications, and supplements. However, many lactose-free alternatives are available, such as lactose-free milk, cheese, and yogurt.
Probiotics
Probiotics are living microorganisms that can enhance digestive health by providing a beneficial balance of bacteria in the gut. Some probiotics, such as Lactobacillus acidophilus, have been found to help the body digest lactose more effectively. Probiotics can be found in supplement form or in certain fermented foods, such as yogurt, kefir, and sauerkraut.
Dairy Digestive Aids
Dairy digestive aids are over-the-counter products that contain lactase enzymes and can be taken with dairy products to aid digestion. These products are available in the form of tablets, capsules, and powders.
Trial and Error
In some cases, it may be necessary to use trial and error to find the best treatment for lactose intolerance. This may involve experimenting with different lactose-free products, lactase supplements, and dairy digestive aids to find what works best for you.
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