Introduction:

People with lactose intolerance cannot fully digest the sugar in milk. As a result, they have diarrhea, gas, and bloating after eating or drinking dairy products. The condition, which is also called lactose malabsorption, is usually harmless, but its symptoms can be uncomfortable.

A deficiency of this enzyme produced in the small intestine is usually responsible for lactose intolerance. Many people have low enzyme levels but can digest dairy products with no problem. However, if you are actually lactose intolerant, your lactase deficiency causes symptoms after eating dairy products.

Most people with lactose intolerance can manage the condition without having to give up all dairy products.

Symptoms

Signs and symptoms of lactose intolerance usually begin 30 minutes to two hours after eating or drinking foods that contain lactose. Common signs and symptoms include:

• Diarrhea

• Nausea and sometimes vomiting

• Abdominal cramps

• Swelling

• Gasoline

Causes

Lactose intolerance occurs when the small intestine does not produce enough of the enzyme (lactase) to digest the sugar in milk (lactose).

Normally, lactase converts milk sugar into two simple sugars, glucose and galactose, which are absorbed into the bloodstream through the intestinal lining.

If you are lactase deficient, lactose from food passes into the colon instead of being processed and absorbed. In the colon, normal bacteria interact with undigested lactose, causing the signs and symptoms of lactose intolerance.

Types of lactose intolerance:

There are three types of lactose intolerance.

1. Primary lactose disease.

This is the most common type. People who develop primary lactose intolerance start life by producing a lot of lactase, a necessity for babies, who get all their nutrients from milk. As children replace milk with other foods, their lactase production normally decreases, but remains high enough to digest the amount of dairy in a typical adult diet.

In primary lactose intolerance, lactase production drops sharply, making dairy products difficult to digest in adulthood. The primary lactose type is genetically determined and occurs in a large proportion of people of African, Asian, or Hispanic descent. The condition is also common among people of Mediterranean or southern European descent.

2. Type of secondary lactose

This form of lactose intolerance occurs when your small intestine decreases lactase production after an illness, injury, or surgery involving your small intestine. Diseases associated with the secondary type include celiac disease, bacterial overgrowth, and Crohn’s disease. Treatment of the underlying disorder can restore lactase levels and improve signs and symptoms, although it may take time.

3. Congenital or developmental intolerance

It is possible, but rare, for babies to be born with a disease caused by a complete lack of enzyme activity. This disorder is passed from generation to generation in an inheritance pattern called autosomal recessive, which means that both the mother and the father must pass on the same genetic variant for a child to be affected.

Risk factor’s:

Factors that can make you or your child more likely include:

• Growing age. It usually appears in adulthood. The condition is rare in infants and young children.

• Ethnicity. more common in people of African, Asian, Hispanic, and American Indian descent.

• Premature birth. Babies born prematurely may have reduced levels because the small intestine does not develop lactase-producing cells until late in the third trimester.

• Diseases that affect the small intestine. Small intestine problems that can cause this disease include bacterial overgrowth, celiac disease, and Crohn’s disease.

• Certain cancer treatments. If you have had radiation therapy for cancer in the abdomen or have intestinal complications from chemotherapy, you are at increased risk.

Diagnosis:

This measures your body’s reaction to a liquid that contains high levels. Two hours after drinking the liquid, you will have blood tests to measure the amount of glucose in your bloodstream. If your glucose level is not rising, it means your body is not properly digesting and absorbing the lactose-filled drink.

• Hydrogen breath test.

This test also requires you to drink a liquid that contains high levels. Your doctor then measures the amount of hydrogen in your breath at regular intervals. Normally, very little hydrogen is detected. However, if your body doesn’t digest the protein, it will ferment in your colon, releasing hydrogen and other gases, which are absorbed by your intestines and eventually exhaled. Larger than normal amounts of exhaled hydrogen measured during a breath test indicate that you are not fully digesting and absorbing lactose.

• Stool acidity test.

For babies and children who cannot undergo other tests, a stool acidity test may be used. Fermentation of undigested protein creates lactic acid and other acids that can be detected in a stool sample.

Treatment:

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

• Avoid large servings of milk and other dairy products.

• Include small portions of dairy products in your regular meals.

• Eat and drink reduced protein ice cream and milk.

• Drink regular milk after adding a liquid or powder to break down the lactose.

Home remedies:

Maintain good nutrition

Cutting back on dairy doesn’t mean you can’t get enough calcium. Calcium is found in many other foods, such as:

• Broccoli

• Calcium-fortified products, such as breads and juices

• Canned salmon

• Milk substitutes, such as soy milk and rice milk

• oranges

• Pinto beans

• rhubarb

• Spinach

Limit dairy products

• Choose smaller servings of dairy products.

Drink small portions of milk, up to 4 ounces (118 milliliters) at a time. The smaller the serving, the less likely it is to cause gastrointestinal problems.

• Save milk for meals.

Drink milk with other foods. This slows down the digestive process and can lessen symptoms.

• Experiment with a variety of dairy products.

Not all dairy products have the same amount of protein. For example, hard cheeses, such as Swiss or cheddar, have small amounts of protein and usually do not cause symptoms. You may be able to tolerate cultured dairy products, such as yogurt, because the bacteria used in the culture process naturally produce the enzyme that breaks down lactose.

• Purchase of lactose-free products.

You can find these products in most supermarkets in the refrigerated dairy section.

• Use of enzyme tablets or drops.