19/04/2021
LACTOSE INTOLERANCE
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What is lactose intolerance?
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Lactose intolerance is a condition in which you have digestive symptoms—such as bloating, diarrhea, and gas—after you consume foods or drinks that contain lactose. Lactose is a sugar that is naturally found in milk and milk products, like cheese or ice cream.
In lactose intolerance, digestive symptoms are caused by lactose malabsorption. Lactose malabsorption is a condition in which your small intestine cannot digest, or break down, all the lactose you eat or drink.
Most people with lactose intolerance can consume some amount of lactose without having symptoms. Different people can tolerate different amounts of lactose before having symptoms. Lactose intolerance is different from a milk allergy. A milk allergy is an immune system disorder.
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How common is lactose malabsorption?
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While most infants can digest lactose, many people begin to develop lactose malabsorption—a reduced ability to digest lactose—after infancy. Experts estimate that about 68 percent of the world’s population has lactose malabsorption.
What are the complications of lactose intolerance?
Milk and milk products, which contain lactose, are some of the main sources of calcium, vitamin D, and other nutrients. You need calcium throughout your life to grow and have healthy bones. If you don’t get enough calcium, your bones may become weak and more likely to break. This condition is called osteoporosis . If you have lactose intolerance, you can change your diet to make sure you get enough calcium while also managing your symptoms.
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What are the symptoms of lactose intolerance?
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If you have lactose intolerance, you may have symptoms within a few hours after you have milk or milk products, or other foods that contain lactose. Your symptoms may include
• bloating
• diarrhea
• gas
• nausea
• pain in your abdomen
• stomach “growling” or rumbling sounds
• vomiting
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What causes lactose intolerance?
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- Lactose is a disaccharide, or a molecule made up of two types of sugars, in this case, glucose and galactose. Most people have an enzyme (a protein molecule that breaks down other molecules) LACTASE in their digestive systems. This enzyme breaks down lactose into glucose and galactose. The body can then absorb and use these sugars for energy. When someone has a lactase deficiency, lactose cannot be digested and remains in the digestive system.
- Babies' digestive systems are designed to survive only on breast milk. In order to digest milk, babies produce the enzyme lactase. It breaks down the lactose (kind of sugar found in milk) in the bowel so that the body can process it further. When a child is weaned off breast milk, their digestive system gradually adapts to other foods. Their body then produces considerably less lactase, and can therefore only break down smaller amounts of lactose.
- If an adult consumes more lactose than their body can break down with the available lactase, the excess lactose remains in the bowel. It passes on into the large intestine, where it is digested by intestinal bacteria (fermentation). This leads to the increased production of gas and other byproducts, which cause the problems.
Following conditions are the conditions can lead to low levels of lactase in your small intestine and lactose malabsorption:
• Primary lactase deficiency - In people with lactase non-persistence, the small intestine makes less lactase after infancy. Lactase levels get lower with age. It is also called primary lactase deficiency, is the most common cause of low lactase levels.
• Congenital lactase deficiency - In this rare condition, the small intestine makes little or no lactase, starting at birth.
• Injury to the small intestine - Infections, diseases, or other conditions that injure your small intestine, like Crohn’s disease or celiac disease, medicines, surgery, or radiation therapy.
• Premature birth - In premature babies, or babies born too soon, the small intestine may not make enough lactase for a short time after birth. The small intestine usually makes more lactase as the baby gets older.
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How to diagnose lactose intolerance?
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- To diagnose lactose intolerance, you can do an elimination diet followed by a "lactose stress test." This involves avoiding milk or dairy products for a certain amount of time, and then drinking a lactose solution at a doctor's practice. Your body's reaction to that is then monitored.
- A lactose tolerance test measures blood sugar levels before and several times after drinking a lactose solution. This makes it possible to find out whether the body is able to break down and absorb the lactose.
- A breath test can also be done. This measures the hydrogen content of your breath after drinking a lactose solution. The amount of hydrogen in breath is normally higher in people who are lactose intolerant.
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What is Treatment for lactose intolerance symptoms?
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There is no treatment that can "cure" primary lactose intolerance. But it's possible to live a symptom-free life by changing your diet.
In the case of secondary lactose intolerance, it's important to find the exact cause and have it treated. If the lining of the intestine improves through treatment, the symptoms will go away.
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How to deal in everyday meals if having lactose intolerance?
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Using lactose-free and lactose-reduced milk and milk products may help you lower the amount of lactose in your diet. If you are lactose intolerant, make sure you get enough calcium and vitamin D each day. Milk and milk products are the most common sources of calcium. Many foods that do not contain lactose are also sources of calcium, such as:
• fish with soft bones, such as canned salmon or sardines
• broccoli and leafy green vegetables, green cabbage
• oranges
• almonds, nuts, and dried beans
• tofu
• products with labels that show they have added calcium, such as some cereals, fruit juices, and soy milk.
- If you find it too hard to give up dairy completely, you can test how much lactose you tolerate and then spread that amount out across your day in combination with other foods.
- People with severe lactose intolerance usually don't eat any dairy products at all, although it can be difficult to avoid them if you eat out. Instant meals also often contain lactose. Some people then take dietary supplements to prevent a reaction.
- Dietary supplements containing the enzyme lactase are available in the form of tablets and capsules. They are meant to help the body break down lactose. But there is no scientific proof that they work. The few studies that were done on these dietary supplements didn't show that they improved or prevented the symptoms.
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Which Foods contain lactose?
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Lactose is in all milk and milk products and may be found in other foods and drinks. If you have symptoms after consuming a small amount of lactose, you should be aware of the many products that may contain lactose, such as
• bread and other baked goods, such as pancakes, biscuits, cookies, and cakes
• processed foods, including breakfast cereals, instant potatoes, soups, margarine, salad dressings, and flavored chips and other snack foods
• processed meats
• milk-based meal replacement liquids and powders, smoothies, and protein powders and bars
• nondairy liquid and powdered coffee creamers, and nondairy whipped toppings
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References
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https://en.wikipedia.org/wiki/Lactose_intolerance
https://en.wikipedia.org/wiki/Lactose
https://www.ncbi.nlm.nih.gov/pubmed/19889824
https://www.mayoclinic.org/diseases-conditions/lactose-intolerance/symptoms-causes/syc-20374232
https://www.ncbi.nlm.nih.gov/books/NBK310267/
https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/all-content
https://www.medicalnewstoday.com/articles/180120.php