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Lactose Intolerance

Lactose Intolerance

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Published by Nader Smadi

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Published by: Nader Smadi on Feb 07, 2009
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05/10/2014

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Lactose Intolerance
Definition

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 \u2014 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.

You can control symptoms of lactose intolerance through a carefully chosen diet that
limits lactose without cutting out calcium, and possibly by taking supplements.
Symptoms

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:

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Diarrhea, which is the most common symptom
\ue000
Nausea
\ue000
Abdominal cramps
\ue000
Bloating
\ue000
Gas

Symptoms are usually mild but may sometimes be severe. The severity of symptoms doesn't correlate with the degree of lactose malabsorption. Instead, symptoms relate to a range of factors, including ethnicity, age and how fast you digest food.

Lactose intolerance isn't easily diagnosed by signs and symptoms alone. Many other conditions, including stomach flu and irritable bowel syndrome, can give you similar symptoms. In young children, diarrhea along with certain other symptoms may be a sign of milk protein allergy.

Causes
Small intestine

The cells that line your small intestine produce an enzyme called lactase. Lactase
breaks down lactose into two simple sugars \u2014 glucose and galactose \u2014 which can be
absorbed into your bloodstream. Without lactase, the unprocessed lactose moves on to
the colon, where the normal intestinal bacteria contend with it. This causes the
hallmarks of lactose intolerance \u2014 gas, bloating and diarrhea.

There are three types of lactose intolerance.
Normal result of aging for some people (primary lactose intolerance)

Normally, your body produces large amounts of lactase at birth and during early
childhood, when milk is the primary source of nutrition. Usually your lactase
production decreases as your diet becomes more varied and less reliant on milk. This
gradual decline may cause symptoms of lactose intolerance.

Result of illness or injury (secondary lactose intolerance)

This form of lactose intolerance occurs when your small intestine decreases lactase
production after an illness, surgery or injury to your small intestine. It can occur as a
result of intestinal diseases, such as celiac disease, gastroenteritis or an inflammatory
bowel disease like Crohn's disease. This type of lactose intolerance may last only a
few weeks and be completely reversible. However, if it's caused by a long-term
illness, it may be permanent.

Condition you're born with (congenital lactose intolerance)

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.
These babies require lactose-free infant formulas.
Risk factors
A few risk factors can make you or your child more prone to lactose intolerance:
\ue000
Age. Lactose intolerance usually starts after age 5 \u2014 the condition is
uncommon in babies and young children. A child with chronic diarrhea before
age 1 usually has another underlying problem.
\ue000
Ethnicity. Lactose intolerance is more common in certain ethnic and racial
populations. Lactose intolerance is more common in black, Asian, Hispanic
and American Indian populations.
\ue000
Premature birth. Infants born prematurely (28 to 32 weeks of gestation) may
have reduced levels of lactase, because this enzyme increases in the fetus late
in the third trimester.
When to seek medical advice

If you have signs and symptoms of lactose intolerance, talk to your doctor. Don't diagnose yourself. Your symptoms could be an indication of another illness. Your doctor can help determine if you have lactose intolerance or another condition.

Tests and diagnosis

Your doctor may diagnose lactose intolerance based on your symptoms and your
response to reducing the amount of dairy foods in your diet. Your doctor can confirm
the diagnosis by conducting one or more of the following tests:

\ue000
Lactose tolerance test. You'll need to avoid eating before this test, to ensure

accurate results. Once at the doctor's office, you'll drink a liquid that contains
high levels of lactose. When this lactose reaches your digestive system, the
lactase enzyme normally breaks it down into glucose and galactose, which can
be absorbed by your bloodstream. In this test, you'll give blood samples over a
two-hour period to measure your glucose level. If your glucose level isn't
rising, it means you aren't properly digesting and absorbing the lactose-filled
drink.

\ue000
Hydrogen breath test. This test also requires you to drink a liquid that

contains high levels of lactose. Then your doctor measures the amount of
hydrogen in your breath at regular intervals. Normally, very little hydrogen is
detectable. However, undigested lactose reaches your colon and ferments,
causing hydrogen and other gases to be released, absorbed by your intestines,
and eventually exhaled. Large amounts of exhaled hydrogen indicate that you
aren't fully digesting and absorbing lactose and that you're probably intolerant.

\ue000
Stool acidity test. Infants and children suspected of having lactose intolerance

take a stool acidity test. The amount of lactose required for the lactose
tolerance test or the hydrogen breath test may be dangerous for infants and
children. The stool acidity test measures the amount of acid in the stool.

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