About lactose intolerance

What is lactose intolerance?

Lactose intolerance is the inability to digest and absorb lactose (the sugar in milk) that results in gastrointestinal symptoms when milk or food products containing milk are consumed.

What are the symptoms for lactose intolerance?

The 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:

When to see a doctor

Make an appointment with your doctor if you frequently have symptoms of lactose intolerance after eating dairy foods, particularly if you're worried about getting enough calcium.

What are the causes for lactose intolerance?

Lactose intolerance occurs when your small intestine doesn't produce enough of an enzyme (lactase) to digest milk sugar (lactose).

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

If you're lactase deficient, lactose in your food moves 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.

There are three types of lactose intolerance. Different factors cause the lactase deficiency underlying each type.

Primary lactose intolerance

This is the most common type of lactose intolerance. People who develop primary lactose intolerance start life producing plenty of lactase — a necessity for infants, who get all their nutrition 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 falls off sharply, making milk products difficult to digest by adulthood. Primary lactose intolerance is genetically determined, occurring in a large proportion of people with African, Asian or Hispanic ancestry. The condition is also common among those of Mediterranean or Southern European descent.

Secondary lactose intolerance

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

Congenital or developmental lactose intolerance

It's possible, but rare, for babies to be born with lactose intolerance caused by a complete absence of lactase activity. This disorder is passed from generation to generation in a pattern of inheritance called autosomal recessive, meaning that both the mother and the father must pass on the same gene variant for a child to be affected. Premature infants may also have lactose intolerance because of an insufficient lactase level.

What are the treatments for lactose intolerance?

Dietary changes

The most obvious means of treating lactose intolerance is by reducing the amount of lactose in the diet. Fortunately, most people who are lactose intolerant can tolerate small or even moderate amounts of lactose. It often takes only elimination of the major milk-containing products to obtain sufficient relief from their symptoms. Thus, it may be necessary to eliminate only milk, yogurt, cottage cheese, and ice cream. Though yogurt contains large amounts of lactose, it often is well-tolerated by lactose intolerant people. This may be so because the bacteria used to make yogurt contain lactase, and the lactase is able to split some of the lactose during storage of the yogurt as well as after the yogurt is eaten (in the stomach and intestine). Yogurt also has been shown to empty more slowly from the stomach than an equivalent amount of milk. This allows more time for intestinal lactase to split the lactose in yogurt, and, at least theoretically, would result in less lactose reaching the colon.

Most supermarkets carry milk that has had the lactose already split by the addition of lactase. Substitutes for milk also are available, including soy and rice milk. Acidophilus-containing milk is not beneficial since it contains as much lactose as regular milk, and acidophilus bacteria do not split lactose.

For individuals who are intolerant to even small amounts of lactose, the dietary restrictions become more severe. Any purchased product containing milk must be avoided. It is especially important to eliminate prepared foods containing milk purchased from the supermarket and dishes from restaurants that have sauces.

Another means to reduce symptoms of lactose intolerance is to ingest any milk-containing foods during meals. Meals (particularly meals containing fat) reduce the rate at which the stomach empties into the small intestine. This reduces the rate at which lactose enters the small intestine and allows more time for the limited amount of lactase to split the lactose without being overwhelmed by the full load of lactose at once. Studies have shown that the absorption of lactose from whole milk, which contains fat, is greater than from non-fat milk, perhaps for this very reason. Nevertheless, the substitution of whole milk or yogurt for non-fat milk or yogurt does not seem to reduce the symptoms of lactose intolerance.

Lactase enzyme

Caplets or tablets of lactase are available to take with milk-containing foods.

Adaptation

Some people find that by slowly increasing the amount of milk or milk-containing products in their diets they are able to tolerate larger amounts of lactose without developing symptoms. This adaptation to increasing amounts of milk is not due to increases in lactase in the intestine. Adaptation probably results from alterations in the bacteria in the colon. Increasing amounts of lactose entering the colon change the colonic environment, for example, by increasing the acidity of the colon. These changes may alter the way in which the colonic bacteria handle lactose. For example, the bacteria may produce less gas. There also may be a reduction in the secretion of water and, therefore, less diarrhea.

Calcium and vitamin D supplements

Milk and milk-containing products are the best sources of dietary calcium, so it is no wonder that calcium deficiency is common among lactose intolerant persons. This increases the risk and severity of osteoporosis and the resulting bone fractures. It is important, therefore, for lactose intolerant persons to supplement their diets with calcium. A deficiency of vitamin D also causes disease of the bones and fractures. Milk is fortified with vitamin D and is a major source of vitamin D for many people. Although other sources of vitamin D can substitute for milk, it is a good idea for lactose-intolerant persons to take supplemental vitamin D to prevent vitamin D deficiency.

What are the risk factors for lactose intolerance?

Factors that can make you or your child more prone to lactose intolerance include:

  • Increasing age. Lactose intolerance usually appears in adulthood. The condition is uncommon in babies and young children.
  • Ethnicity. Lactose intolerance is most common in people of African, Asian, Hispanic and American Indian descent.
  • Premature birth. Infants born prematurely may have reduced levels of lactase because the small intestine doesn't develop lactase-producing cells until late in the third trimester.
  • Diseases affecting the small intestine. Small intestine problems that can cause lactose intolerance include bacterial overgrowth, celiac disease and Crohn's disease.
  • Certain cancer treatments. If you have received radiation therapy for cancer in your abdomen or have intestinal complications from chemotherapy, you have an increased risk of lactose intolerance.
 

Is there a cure/medications for lactose intolerance?

Lactose intolerance is a common digestive issue where the body is incompetent to digest lactose, which is a type of sugar usually evident in milk and dairy products.

The symptoms of lactose intolerance develop within a few hours of consuming drink or food that contains lactose. The most common symptoms are farting, diarrhea, stomach rumbling, stomach cramps, and a bloated stomach.

Treatment for lactose intolerance
There is no cure for lactose intolerance. However, eliminating drinks and food containing lactose can help in controlling the symptoms.
Lactose-free products are mainly:

  • Lactose-free milk
  • Yogurts, certain cheeses and soy milk
  • Oats, rice, almonds, quinoa, potato milk, hazelnut, coconut
  • The doctor may also prescribe Vitamin D and Calcium supplements
  • The GP usually advise to consume lactase substitutes, which are tablets or drops you can consume with your drinks or meals to enhance lactose digestion.
  • The alternative medicine includes probiotics, which are living organisms present in the intestines. This helps in maintaining a healthy digestive system.
  • Probiotics are available as live or active cultures in some yogurts, as well as supplements in capsule format.
  • Probiotics are considered safe for consumption.
  • Probiotics are also used for specific gastrointestinal conditions such as irritable bowel syndrome and diarrhea.


Conditions
Osteopenia,Osteoporosis,Malnutrition
Drugs
Lactase enzyme tablets or drops,Probiotics
Symptoms
Farting,Diarrhea,Stomach rumbling,Stomach cramps,Bloated stomach

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