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Lactose Intolerance. Symptoms, Causes and Treatment

Lactose intolerance, also called lactase deficiency, means you aren't able to fully digest the milk sugar (lactose) in dairy products. It's not usually dangerous, but symptoms of lactose intolerance can be uncomfortable enough to steer you clear of the dairy aisles. The problem behind lactose intolerance is a deficiency of lactase �" an enzyme produced by the lining of your small intestine. Some people who think they are lactose intolerant actually don't have impaired lactose digestion. And not everyone with low levels of lactase is lactose intolerant. Only people with low lactase levels and symptoms are considered to have lactose intolerance.

Symptoms

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. Symptoms begin about 30 minutes to 2 hours after eating or drinking foods containing lactose. 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.

Teens with the most severe symptoms of lactose intolerance may have to avoid all dairy products. It's extra important that these teens find other good calcium sources, so talking to a registered dietitian is a good idea. Dietitians are trained in nutrition and they can help people who are lactose intolerant come up with eating alternatives and develop a well-balanced diet that provides lots of calcium for developing strong bones.

Causes

Lactose is a larger sugar that is made up of two smaller sugars, glucose and galactose. In order for lactose to be absorbed from the intestine and into the body, it must first be split into glucose and galactose. The glucose and galactose then are absorbed by the cells lining the small intestine. The enzyme that splits lactose into glucose and galactose is called lactase, and it is located on the surface of the cells that line the small intestine.

It's possible for babies to be born with lactose intolerance. This rare disorder is passed from generation to generation in a pattern of inheritance called autosomal recessive. This means that both the mother and the father must pass on the defective form of the gene for a child to be affected. Infants with congenital lactose intolerance are intolerant of the lactose in their mothers' breast milk and have diarrhea from birth.

Sometimes the small intestine stops making lactase after a short-term illness such as the stomach flu, or as part of a lifelong disease such as cystic fibrosis, or after surgery to remove a part of the small intestine. In these cases, the problem can be either permanent or temporary.

Treatment Foods with the highest concentration of lactose by far are milk and icecream, while cheeses and yoghurts generally contain much lower quantities. Most patients find that they can tolerate low levels of lactose in their diet, up to 250ml of milk, which may be enough to maintain calcium intake, however if there is any doubt, calcium supplementation should be considered. Lactose in milk can be predigested by the addition of a commercially available enzyme substitute, which is refrigerated overnight and leads to digestion of virtually 100% of the lactose.

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