Lactose Intolerance

Lactose intolerance is a medical condition characterized by the inability of the body to digest lactose, a sugar found in milk and other dairy products. This occurs when the small intestine does not produce enough lactase, an enzyme that breaks down lactose into easily absorbed sugars.

Causes

Lactose intolerance is caused by a deficiency of lactase enzyme in the small intestine. There are several reasons why this may occur:

• Genetic predisposition: Some people are born with a low level of lactase enzyme, which can lead to lactose intolerance.
• Aging: The production of lactase enzyme decreases with age, making older adults more prone to lactose intolerance.
• Gastrointestinal diseases: Certain conditions such as celiac disease, Crohn's disease, and gastroenteritis can damage the small intestine and lead to lactose intolerance.
• Medications: Some medications, such as antibiotics, can disrupt the balance of gut bacteria and lead to lactose intolerance.

Symptoms

The symptoms of lactose intolerance typically occur within 30 minutes to 2 hours after consuming lactose-containing products. Common symptoms include:

• Bloating and gas: The undigested lactose is fermented by bacteria in the colon, producing gas and leading to bloating.
• Diarrhea: The unabsorbed lactose can draw water into the colon, causing diarrhea.
• Abdominal pain and cramps: The fermentation of lactose can cause abdominal discomfort and cramping.
• Nausea and vomiting: In some cases, lactose intolerance can lead to nausea and vomiting.

Treatments

While there is no cure for lactose intolerance, several treatments can help manage the symptoms:

• Lactase enzyme supplements: These supplements contain the lactase enzyme that breaks down lactose, making it easier to digest.
• Lactose-free or low-lactose products: Many dairy products are now available in lactose-free or low-lactose versions, making it easier for people with lactose intolerance to consume them.
• Hard cheeses and yogurt: Hard cheeses like cheddar and Swiss, as well as yogurt with live cultures, contain less lactose than other dairy products and may be tolerated by some individuals.
• Nondairy milk alternatives: For those who are severely lactose intolerant, nondairy milk alternatives such as almond milk, soy milk, or coconut milk can provide a suitable substitute for cow's milk.
• Dietary changes: Avoiding or reducing lactose-containing products can help alleviate symptoms. A healthcare professional or registered dietitian can help develop a personalized diet plan.

Diagnosis

Lactose intolerance is typically diagnosed through a combination of:

• Medical history and physical examination: A healthcare professional will assess the individual's symptoms, medical history, and perform a physical examination to rule out other conditions.
• Lactose tolerance test: This test measures the body's ability to digest lactose by monitoring blood sugar levels after consuming a lactose-containing drink.
• Hydrogen breath test: This test measures the amount of hydrogen in the breath, which can indicate the presence of undigested lactose in the colon.
• Stool acidity test: This test measures the pH level of stool samples to detect the presence of lactic acid, a byproduct of lactose fermentation.

Complications

If left untreated or poorly managed, lactose intolerance can lead to:

• Malnutrition: Inadequate nutrition due to avoidance of dairy products can lead to malnutrition and deficiencies in essential nutrients like calcium and vitamin D.
• Osteoporosis: Insufficient calcium intake can increase the risk of osteoporosis, particularly in older adults.
• Anemia: Inadequate iron intake due to avoidance of dairy products can lead to anemia.