Lactose intolerance

Description

People with lactose intolerance are unable to digest fully the sugar (lactose) in milk. As a result, they have diarrhea, gas and bloating after eating or drinking dairy products. The condition, which is also called the malabsorption lactose, is usually harmless, but its symptoms can be uncomfortable.

Too little of an enzyme produced in the small intestine (lactase) is usually responsible for lactose intolerance. You may have low levels of lactase and still be able to digest dairy products. But if your levels are too low, they become intolerant to the lactose, producing symptoms after eating or drinking dairy products.

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

Symptoms

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

  • Diarrhea
  • Nausea and sometimes vomiting
  • Cramps in the stomach
  • Swelling
  • Gas

When to see a doctor

Make an appointment with your doctor if you have symptoms of lactose intolerance after consuming dairy products, especially if you are worried about how to get enough calcium.

Causes

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

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

If you have a deficiency of lactase, the lactose in the food moves into the colon instead of being processed and absorbed. In the colon, the normal bacteria interact with the lactose is not digested, causing the signs and symptoms of lactose intolerance.

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

Primary lactose intolerance

People who develop primary lactose intolerance — the most common type of start in life, produces enough lactase. The children, who get all of their nutrients of the milk, the need of lactase.

As the children replace milk with other foods, the amount of lactase that normally produce drops, but usually still high enough to digest the amount of dairy products in a typical diet of the adults. In primary lactose intolerance, lactase production falls sharply upon reaching adulthood, making dairy products difficult to digest.

Secondary lactose intolerance

This form of lactose intolerance occurs when the small intestine decreases the production of lactase after an illness, injury, or surgery in the small intestine. Diseases associated with secondary lactose intolerance include intestinal infection, celiac disease, bacterial overgrowth, and Crohn's disease.

The treatment of the underlying disorder can restore the levels of lactase and improve the signs and symptoms, despite the fact that it can take time.

Congenital or developmental lactose intolerance

It is possible, but rare, the baby may be born with lactose intolerance, caused by a lack of lactase. This disorder is transmitted 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 variant of the gene for a child to be affected. Premature babies may also have lactose intolerance due to an insufficiency of lactase level.

Risk factors

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

  • The increase of the age. Lactose intolerance is usually appear in adulthood. The condition is common in infants and young children.
  • The ethnic origin. Lactose intolerance is more common in people of African, Asian, Hispanic, and American Indian origin.
  • The preterm birth. Babies who are born prematurely may have reduced levels of lactase due to that the small intestine does not develop lactase-producing cells until late in the third quarter.
  • Diseases that affect the small intestine. The small intestine of the 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 the stomach or have intestinal complications of the chemotherapy, your risk of developing lactose intolerance increases.

Lactose intolerance

Diagnosis

Your doctor may suspect lactose intolerance based on your symptoms and your response to the reduction of the amount of dairy products in your diet. Your doctor can confirm the diagnosis by performing one or more of the following tests:

  • The breath test hydrogen. After drinking a liquid that contains high levels of lactose, the doctor measures the amount of hydrogen in your breath at regular intervals. Breathing too much hydrogen indicates that you are not completely digestion and absorption of lactose.
  • Test lactose tolerance. Two hours after drinking a liquid that contains high levels of lactose, you are going to have blood tests to measure the amount of glucose in the bloodstream. If your blood glucose level does not go up, it means that your body is not properly in the digestion and absorption of lactose-filled drink.

Treatment

In people with lactose intolerance caused by an underlying disease, the treatment of the condition could restore the body's ability to digest lactose, despite the fact that the process can take months. For other reasons, you can avoid the discomfort of lactose intolerance after a low-lactose diet.

To reduce the amount of lactose in your diet:

  • Limit the consumption of milk and other dairy products
  • They are small servings of dairy products in their regular meals
  • Eat and drink lactose-reduced ice cream and milk
  • Add a liquid or powder form of the enzyme lactase to the milk to break down the lactose

Self-care

With a little trial and error, you might be able to predict the response of your body to the foods that contain lactose, and find out how much you can eat or drink without discomfort. Few people have a strong intolerance to lactose that have to cut out all the products of the milk and take care of non-dairy foods or medications that contain lactose.

Maintain good nutrition

The reduction of dairy products does not mean that you cannot get enough calcium. Calcium is found in many other foods, such as:

  • The broccoli and green leafy vegetables
  • Calcium-fortified products, such as cereals and juices
  • Salmon, or sardines, canned
  • Milk substitutes such as soy milk and rice milk
  • Oranges
  • Almonds, Brazil nuts, and dried beans.

Also make sure you get enough vitamin D, normally supplied in the fortified milk. Eggs, liver, and yogurt also contains vitamin D, and your body produces vitamin D when you spend time in the sun.

Even without the restriction of dairy foods, however, many adults do not get enough vitamin D. Talk with your doctor about taking vitamin D and calcium supplements to be sure.

Limit dairy products

Most people with lactose intolerance can enjoy some of the milk products without symptoms. You could tolerate low-fat dairy products, such as skim milk, better than whole milk products. It could also be possible to increase your tolerance to dairy products by gradually introducing in your diet.

Ways to change your diet to minimize symptoms of lactose intolerance include:

  • The choice of small portions of dairy. Sip small portions of milk — up to 4 ounces (118 milliliters) at a time. The smaller the portion, the less likely it is to cause gastrointestinal problems.
  • Save the milk for feeding time. Drink milk with other food. This slows down the digestive process and can relieve the symptoms of lactose intolerance.
  • Experimenting with a variety of dairy products.Not all dairy products have the same amount of lactose. For example, hard cheeses, such as Swiss or cheddar, they have small amounts of lactose and usually do not cause symptoms. Ice cream and milk contain most of the lactose, but the high fat content of the ice cream you can eat without symptoms. You could tolerate cultured dairy products, like yogurt, because the bacteria used in the cultivation of the natural process of producing the enzyme that breaks down lactose.
  • The purchase of a lactose-reduced or lactose-free products. You can find these products in most supermarkets in the section of dairy.
  • The use of the lactase enzyme tablets or drops. Over-the-counter pills or drops that contain the enzyme lactase (Lactaid, others) may help to digest dairy products. You can take the tablets before each meal or snack. Or the drops can be added to a carton of milk. These products do not help you to everyone who has lactose intolerance.

Experimenting with a variety of dairy products. Not all dairy products have the same amount of lactose. For example, hard cheeses, such as Swiss or cheddar, they have small amounts of lactose and usually do not cause symptoms.

Ice cream and milk contain most of the lactose, but the high fat content of the ice cream you can eat without symptoms. You could tolerate cultured dairy products, like yogurt, because the bacteria used in the cultivation of the natural process of producing the enzyme that breaks down lactose.

Alternative medicine

Probiotics

Probiotics are living organisms present in the gut that help maintain a healthy digestive system. Probiotics are also available as active or "live" cultures in some yogurts and as supplements in the form of capsules.

Sometimes it is used for gastrointestinal disorders, such as diarrhea and irritable bowel syndrome. They can also help your body digest the lactose. Probiotics are generally considered safe and may be worth a try if other methods do not help.

Preparing for your appointment

Start by seeing your family doctor if you have signs or symptoms that suggest you may have lactose intolerance. Here's some information to help you prepare.

What you can do

When you make your appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.

Make a list of:

  • Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they occur
  • All medications, vitamins or supplements that you are taking, including dose
  • Questions to ask your doctor

Questions to ask your doctor about the lactose intolerance may include:

  • There are other possible causes for my symptoms in addition to lactose intolerance?
  • What tests do I need?
  • What are my treatment options?
  • Should I stop eating all dairy products?
  • How can I be sure that I'm getting enough calcium in the diet?
  • Should I see a dietitian?
  • I have these other health conditions. How can I best manage these conditions?
  • Are there brochures or other printed material I can have? What sites do you recommend?

What you can do in the meantime

Keep track of your daily servings of dairy, such as milk, ice cream, yogurt, and cottage cheese, and when you have them and what you eat with them. Also let your doctor know that dairy products, in what quantities, to give symptoms. This information can help your doctor make a diagnosis.

If you think you may be lactose-intolerant, try cutting dairy from your diet for a couple of days to see if your symptoms ease. Let your doctor know if your symptoms was better in the days that don't have dairy products.

Symptoms and treatment of Lactose intolerance