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Lactose Intolerance

lactose intolerance

Lactose is a sugar found in milk. It cannot become absorbed by the body unless is gets changed into glucose and galactose. This change happens when the lactose passes through the stomach into the upper part of the small intestine and comes into contact with a chemical called lactase.Lactase is made by cells that line the upper part of the small intestine.
If there is not enough lactase in the upper bowel, lactose cannot be broken down and cannot get absorbed. This leads to lactose intolerance.

You may confuse lactose intolerance with allergy to cow's milk. With milk allergy, your immune system reacts to proteins found in milk which can cause symptoms. Lactose intolerance is not an allergy. Symptoms are caused by the undigested lactose in the gut.

What causes lactose intolerance?

Inherited forms: these are passed on through families.

  • Primary lactase deficiency: this causes low levels of lactase. Symptoms can develop at any age but rarely before the age of six.
  • Congenital lactase deficiency: this causes a complete lack of lactase from birth. Symptoms develop as soon as the baby is given milk or lactose formula.
  • Secondary lactase deficiency: this happens when something damages the cells in the lining of the upper small intestine which produce lactase. It is common in children and often occurs after a stomach infection (such as viral or bacterial gastroenteritis).
  • Developmental lactase deficiency: when a baby is born, it takes time for a reasonable amount of lactase to build up in the digestive system. Babies more than six weeks premature may have temporary lactose intolerance. The condition disappears as the baby gets older.

What are the symptoms of lactose intolerance?

You may get bloating, or stomach pains. Excessive burping or passing a lot of wind can occur. You may also get watery diarrhea, and itching around the anus.

How is lactose intolerance diagnosed?

If you get symptoms after drinking milk or eating dairy products or other lactose-containing foods, it is fairly clear that you have lactose intolerance. Tests are not usually needed.
If there is any doubt, a special test can be performed which involves measuring the amount of hydrogen you breathe after taking a test dose of lactose. Rarely, you may need an intestinal biopsy to make the diagnosis.

What is the treatment of lactose intolerance?

Babies and young children with primary lactose intolerance (the inherited form) should be tested to find out how much lactose they can handle. People do have varying levels of intolerance.

Lactase from yeast can be added to improve absorption even more. Thicker foods such as yoghurts and curds are likely to be better tolerated because they move through the bowel at a slower rate.

Secondary lactose intolerance may need treatment by fluid through a drip if the diarrhea is very severe. Most doctors advise parents of babies and children with gastroenteritis to carry on with breast milk, formula milk or cow's milk but, if the diarrhea is very prolonged, some doctors recommend withdrawing lactose for three weeks after the infection.
The chance of premature babies getting lactose intolerance due to developmental lactase deficiency can be reduced by feeding them half-strength lactose formula or breast milk.

To access the best possible advice, ask your doctor about seeing a dietician.


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