February 10, 2014

Lactose intolerance

      Lactose intolerance means the body cannot easily digest lactose, a type of natural sugar found in milk and dairy products. This is not the same thing as a food allergy to milk. A big challenge for people who are lactose-intolerant is learning how to eat to avoid discomfort and to get enough calcium for healthy bones.
  


What causes lactose intolerance?

     The cause of lactose intolerance is best explained by describing how a person develops lactase deficiency.
       Primary lactase deficiency develops over time and begins after about age 2 when the body begins to produce less lactase. Most children who have lactase deficiency do not experience symptoms of lactose intolerance until late adolescence or adulthood.
     Researchers have identified a possible genetic link to primary lactase deficiency. Some people inherit a gene from their parents that makes it likely they will develop primary lactase deficiency. This discovery may be useful in developing future genetic tests to identify people at risk for lactose intolerance.
     Secondary lactase deficiency results from injury to the small intestine that occurs with severe diarrheal illness, celiac disease, Crohn's disease, or chemotherapy. This type of lactase deficiency can occur at any age but is more common in infancy.

What are the symptoms of lactose intolerance?

   People with lactose intolerance may feel uncomfortable 30 minutes to 2 hours after consuming milk and milk products. Symptoms range from mild to severe, based on the amount of lactose consumed and the amount a person can tolerate.

Common symptoms include

  • Abdominal pain
  • Abdominal bloating
  • Gas
  • Diarrhea
  • Nausea

How is lactose intolerance diagnosed?

Two tests are commonly used to measure the digestion of lactose.
Hydrogen Breath Test:The person drinks a lactose-loaded beverage and then the breath is analyzed at regular intervals to measure the amount of hydrogen. Normally, very little hydrogen is detectable in the breath, but undigested lactose produces high levels of hydrogen. Smoking and some foods and medications may affect the accuracy of the results. People should check with their doctor about foods and medications that may interfere with test results.
Stool Acidity Test : The stool acidity test is used for infants and young children to measure the amount of acid in the stool. Undigested lactose creates lactic acid and other fatty acids that can be detected in a stool sample. Glucose may also be present in the stool as a result of undigested lactose.

How is lactose intolerance managed?

     Although the body's ability to produce lactase cannot be changed, the symptoms of lactose intolerance can be managed with dietary changes.
     Lactose-free and lactose-reduced milk and milk products, available at most supermarkets, are identical to regular milk except that the lactase enzyme has been added. 
    Lactase enzyme :Caplets or tablets of lactase are available to take with milk-containing foods.

Lactose Intolerance and Calcium Intake

    Milk and milk products are a major source of calcium and other nutrients. Calcium is essential for the growth and repair of bones at all ages. Getting enough calcium is important for people with lactose intolerance when the intake of milk and milk products is limited. Many foods can provide calcium and other nutrients the body needs. Non-milk products that are high in calcium include fish with soft bones such as salmon and sardines and dark green vegetables such as spinach. Calcium is absorbed and used in the body only when enough vitamin D is present. Some people with lactose intolerance may not be getting enough vitamin D. Vitamin D comes from food sources such as eggs, liver, and vitamin D-fortified milk and yogurt.

What other products contain lactose?

      Milk and milk products are often added to processed foods—foods that have been altered to prolong their shelf life. People with lactose intolerance should be aware of the many food products that may contain even small amounts of lactose, such as
  • Bread and other baked goods
  • Waffles, pancakes, biscuits, cookies, and mixes to make them
  • Processed breakfast foods such as doughnuts, frozen waffles and pancakes, toaster pastries, and sweet rolls
  • Processed breakfast cereals
  • Instant potatoes, soups, and breakfast drinks
  • Potato chips, corn chips, and other processed snacks
  • Processed meats, such as bacon, sausage, hot dogs, and lunch meats
  • Margarine
  • Salad dressings
  • Liquid and powdered milk-based meal replacements
  • Protein powders and bars
  • Candies
  • Non-dairy liquid and powdered coffee creamers
  • Non-dairy whipped toppings

Points to Remember

  • Lactose intolerance is the inability or insufficient ability to digest lactose, a sugar found in milk and milk products.
  • Lactose intolerance is caused by a deficiency of the enzyme lactase, which is produced by the cells lining the small intestine.
  • Not all people with lactase deficiency have digestive symptoms, but those who do may have lactose intolerance.
  • Most people with lactose intolerance can tolerate some amount of lactose in their diet.
  • People with lactose intolerance may feel uncomfortable after consuming milk and milk products. Symptoms can include abdominal pain, abdominal bloating, gas, diarrhea, and nausea.
The symptoms of lactose intolerance can be managed with dietary changes.
      Getting enough calcium and vitamin D is a concern for people with lactose intolerance when the intake of milk and milk products is limited. Many foods can provide the calcium and other nutrients the body needs.Talking with a doctor or registered dietitian may be helpful in planning a balanced diet that provides an adequate amount of nutrients—including calcium and vitamin D—and minimizes discomfort. A health professional can determine whether calcium and other dietary supplements are needed.

Source

                digestive.niddk
                Medicinenet
                Mayoclinic
                Picture

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