Lactose intolerence occurs when a person who has recently consumed a dairy or milk product, will begin to experience mild to severe symptoms that include stomach cramping, flatulence and/or diarrhea.
The body is unable to digest the lactose or milk sugar found in dairy and milk products resulting in uncomfortable symptoms. This inability to digest lactose is usually because of a shortage of lactase, the enzymes found on the wall lining of the small intestine. The lactase digest and absorb the lactose. If lactose is not broken down into Glucose and absorbed, it will ferment in the body causing bloating, cramping, bloating gas, diarrhea, nausea and other related lactose intolerence symptoms.
Causes of Lactose Intolerance Symptoms in Children and Adults
Lactose intolerance: When the body is unable to absorb and digest lactose/milk sugar found in milk products. This is usually a result of not enough lactase in the body. Lactose needs to be broken down into galactose and glucose so the body can absorb this in the small intestine by wall lining cells and used as energy by the body. Lactase is the enzyme that is supposed to split lactose and can be found on the wall cells in the small intestine. When a product containing lactose is consumed this may result in gastrointestinal problems. These include flatulence, diarrhea and abdominal cramps.
There are three main causes of Lactase intolerance symptoms in children and adults:
- Hypolactasia /developmental causes
This is a rare condition caused by a gene mutation that is accountable for producing the enzyme Lactase. The gene mutation causes the congenital absence of lactase resulting in a deficiency. This lack of lactase begins from birth and symptoms begin to appear shortly after.
This is another cause of lactase deficiency and lactose intolellerant symptoms in children and adults resulting from a disease that has destroyed the lining of the small intestine. The lining has cells that hold lactase and antibiotics or diseases usually destroy these.
Hypolactasia / developmental
This is the most common cause of lactase deficiency and lactose intolerance symptoms in children. It begins from childhood and continues into adulthood. There is a decrease in lactase over the years that are programmed in the genes. The rate of the decrease, and the age the symptoms appear, varies within different ethnic groups. There is a need to distinguish between lactase deficiency and lactose intolerance symptoms. There are people who have mild cases of lactase deficiency and even moderate cases, when the people will consume products containing milk sugar and not actually experience symptoms afterwards. This difference determines whether a person is lactose intolerance or has a case of lactase deficiency. A person with lactose intolerance may have developmental cause and will experience symptoms. A diagnosis is only made if a person experiences symptoms whereas a lactase deficiency diagnosis is only made when a reduction of lactase in the intestine is made. This is one of the main causes of lactose intolerance symptoms in children.
How People with Lactose Intolerant Symptoms are Diagnosed
There are many people who have self diagnosed themselves as being lactose intolerant. There is a case in which one fifth of people think they have this condition if they experience lactose intolerant symptoms, when they are actually not lactose intolerant. The same goes for the one fifth of people who do not think they are lactose intolerant actually are. Because lactose intolerant is a well known condition many people just assume they if they have lactose intolerant symptoms that they are lactose intolerant when really these symptoms could be caused by something completely different. When these symptoms are properly tested the cause can be quickly become known. There are a series of tests to determine if someone is lactose intolerant. It is always best to check with your doctor so he/she can give correct instructions to help diagnose a cause for lactose intolerant symptoms.
There are several ways to diagnose someone who is experiencing lactose intolerant symptoms:
- The Elimination Diet
- Breath test
- Milk test
- Intestinal Biopsy
- Blood Glucose test
- Stool acidity test
The Elimination Diet
This is the most common way people tend to self diagnose lactose intolerant. This diet eliminates milk and milk products containing lactose. If all products containing milk sugar are not eliminated, many prepared food items contain a small amount of milk, many people still experience lactose intolerant symptoms and will believe that these are not caused by lactose intolerance. This type of diet needs to have trials over a period of weeks, rather than days to ensure it is a subjective and accurate test. A placebo effect can also occur, in which the person thinks they feel better when actually they are not better. If this diet is to be taken seriously, it needs to be applied with help of a dietitian or a detailed lactose elimination diet book.
The milk test is conducted when a person does not eat overnight then drinks about a glass of milk first thing in the morning. Within several hours, symptoms should appear, if the person is lactose intolerant. If symptoms do not appear, it is likely that something else is causing the lactose intolerant symptoms. In young children and infants, milk allergies can sometimes be the reason for symptoms, only lactose should be taken instead of milk. There are several factors that can give the test an incorrect result. These include, not drinking more milk than they would usually and confusing large amounts of milk that cause lactose intolerant symptoms and small amounts that cause no symptoms resulting in another reason for the cause.
The Breath Test
This is a common, convenient and accurate way to test for lactose intolerant and lactase deficiency. A person consuming about 25 grams of lactose conducts this test. They will fast overnight and be ingested with water. In the morning breath samples are taken every 15 minutes up to 5 hours, and analyzed for methane or hydrogen. If there are traces of hydrogen or methane found, this means that the small intestine was unable to digest and absorb all of the lactose causing the traces of hydrogen/ methane. If high levels of either were recorder the more severe the deficiency. This is not an indication of the severity of the symptoms. The factors that can give an inadequate result of the test include the amount of lactose taken, a destroyed lining in the small intestine, other conditions resulting in high traces of methane/ hydrogen.
The Blood Glucose Test
This test consists of lactose ingested in the morning after an overnight fast to diagnose a person who experiences from lactose intolerant symptoms. Blood samples are taken and analyzed for Glucose. The samples are then tested for levels of normality of lactase. There are several reasons that conclude for this test to be hardly used. These include the need for multiple blood samples taken, false positive tests, and abnormal tests in people who have normal lactase levels.
The Stool Acid Test
This test is mainly used to detect lactase deficiency and test lactose intolerant symptoms in young children and infants. The person will consume a small amount of lactose. Several hours later the stools samples are tested for acidity. If the person is lactase deficient then the stool should be very acidic. This test is carried out infrequently due to it's superior breath test is much easier to conduct and very similar.
The Intestinal Biopsy Test
This test is conducted with the use of endoscopy or capsules that are then analyzed for lactase levels. This type of testing is mainly used for research, as the specialized analysis of lactase levels in the biopsy requires procedures that are not always available.
What You Should Know about Lactose Intolerence Symptoms
Common symptoms of lactose intolerence include:
- Abdominal pain
Uncommon lactose intolerence symptoms include:
- Abdominal bloating
- Abdominal distention
The lactose that has not been absorbed into the body causes lactose intolerence symptoms. The lactose passes into the small intestine and into the colon. When the lactase changes the lactose in glucose and galactose, it releases a hydrogen gas. Part of this gas is responsible for the increase in flatus or passing gas. The rest is used by other bacteria or expelled in breathing. If the lactose cannot be split by lactase it will bring water into the colon and result in runny, diarrhea.
Generally the more lactose in the diet, the more severe the lactose intolerence symptoms will be but the severity can change in different people. Most people experience mild to severe lactose intolerance symptoms, even if the same amount is consumed between two people. The reason may be due to the difference in intestinal bacteria.
Treatment Available for People with Lactose Intollerance
There are many ways to treat people with lactose Intollerance, these include:
- Changes in diet
- Lactase tablets
- Adaptation to Lactose
Changes in diet
This is the most common and obvious way to dramatically cut lactose from a diet and treat lactose intollerance in patients. Although many people with lactose intollerance can actually tolerate a small amount of lactose in their diet, there is only need to cut main milk groups from a diet. It is usually only necessary to cut milk, cottage cheese, ice cream and yogurt from the diet. Yogurt can actually be tolerated well by people with lactose intollerance. This may be because of the bacteria that makes yogurt contains lactase. When relief from symptoms has been achieved the right mix of foods not containing lots of lactose can be mixed for a varied diet. For people who cannot tolerate lactose at all, there is need for severe diet restrictions.
These can be used when a lactose intollerance person has recently consumed foods containing milk. Lactase enzyme can be taken in the form of a pill or tablet to help with the digestion and absorption of lactose in the small intestine.
There are vitamin D and Calcium supplements that can be taken orally for lactose intollerance treatment. When milk and milk products are drastically taken out of a diet, there is a need for a replacement for dietary required calcium. If supplements are not taken, this can result in severe long-term conditions that include osteoporosis and then finally bone fractures. Vitamin D deficiency can result in a disease of the bones. There are foods that contain vitamin D to help assist in maintaining an adequate amount consumed daily.
Adaptation to Lactose
There is a solution for lactose intollerance that involves slowly increasing the amount of milk product consumed daily, this over time allows the body to eventually tolerate larger amounts of lactose without symptoms. This changes the way the environment in the colon, the colon bacteria can tolerate lactose and produce less gas or less diarrhea by reducing the amount of water in the colon.
Foods that Lactose Intolerent People Should Avoid
Milk and products made from milk are the main sources for natural lactose. There are many prepared foods that actually have 'hidden' lactose. If you have a very low tolerance to lactose, you should base your lactose intolerent diet on what foods can contain lactose, with those containing even the smallest amounts to be included as well. The following foods should be avoided for an ideal lactose intolerent diet.
The following prepared foods contain 'hidden' lactose. These items should be avoided with a lactose intolerent diet:
- Snacks, lollies and candy bars
- Breakfast cereals that have been processed
- Bread and bakery foods
- Pancakes, biscuits
- Soups, breakfast drinks and instant potatoes
- Salad dressing
- Lunch meats excluding kosher
For people who are undertaking a lactose intolerent diet, they should avoid the many other products that contain 'hidden' lactose. These include whipping toppings and powdered coffee that is labeled as nondairy. Look out for products that contain these words in their labels: nonfat milk powders, milks by products, whey, curds, and dry milk solids. These products usually make a difference for people with severe lactose intolerent symptoms only. All of these items contain lactose. Lactose can also be found in prescription drugs and over the counter medicines. Ups to one fifth of prescription medicines contain lactose.
The Future for Controlling Symptoms of Lactose Intolerance
There are new tests available to make a diagnosis when a person is experiencing symptoms of lactose intolerance. DNA can be taken from the individual and analyzed to diagnose lactose intolerance. This is a rather pricey test and can take a long time to complete.
Scientists discovered in 1998 a way to manipulate a lactose intolerant rat's gene. By transferring the gene for lactase to the lining cells in the intestine. This type of gene therapy will hopefully be adapted for an application for a human being.
Long Term Effects of Lactose Intolerance
If a person with symptoms of lactose intolerant are left untreated; there are many things that can over time harm the body. The most harmful thing a person can do if are experiencing symptoms of lactose intolerance is to avoid milk products and not take vitamin D and calcium supplements to reach the appropriate dietary amounts required.
Vitamin D: This can be normally absorbed through adequate sun exposure as vitamin D synthesis is promoted in the skin from the sunlight. Vitamin D is a vitamin that helps with metabolism of phosphorus and calcium, and intestinal absorption. Vitamin D deficiency can result in bone weakness or Osteomalacia in adults and bone deformity or known as rickets in children. Lack of Vitamin D can be supplemented with Vitamin D capsules that can be taken orally.
Calcium Deficiency: This is when a person has not been having the daily amount of calcium required for a healthy diet. A low level of calcium in their blood can result in abdominal cramps, hand and feet spasms, soft bones, osteoporosis, poor mineralisation of bones and in children can result in impaired growth and rickets.
Glossary for Lactose Intolerence
Acidophilus: This is a good bacteria found in yogurt that can help when consumed to support the natural environment in a person's digestive system. Ideally used to aid when the intestinal bacterial population has been changed due to antibiotics or a disease. This type of yogurt is favored over regular yogurt because of it's great lactose intolerence diet properties.
Allergy: An allergic reaction is caused when the human body reacts to something that has entered the body through an airway and the body has detected this as a foreign substance that must be rid of the body immediately. Many of these "foreign" substances are usually harmless and sometimes include danders, pollen, certain foods and molds.
Biopsy: This is the removal of a piece of tissue from a human body for analysis then finally diagnosis.
Blood glucose: This is primary sugar that is made by the body from food. Glucose is then carried through the bloodstream and used with the help of insulin to provide energy to the cells in the body.
Calcium: This is a vital mineral for strong healthy bones. It is stored in the hard part of a bone and helps with normal blood clotting, muscle contraction, and nervous system maintenance. Calcium can be found in green vegetables, dairy foods, salmon and many other foods. An adult requires an amount of 1,000 to 1,2000 depending on age, daily for an ideal lactose intolerence diet.
Calcium deficiency: This is when a person has not been having the daily amount of calcium required for a healthy lactose intolerence diet. A low level of calcium in their blood can result in abdominal cramps, hand and feet spasms, soft bones, osteoporosis, poor mineralisation of bones and in children can result in impaired growth and rickets.
Flatulence: This is the passing of excess gas from the intestinal tract. A common symptom of lactose intolerence.
Galactose: This makes up half the sugar that is contained in milk. Lactose is made up of galactose and glucose.
Glucose: Also referred to as Dextrose. Glucose is made from fats, carbohydrates, and proteins by the body and is the main sugar the makes. The body for energy with the help of insulin uses glucose.
Lactase: This is an enzyme that is used to break down the milk sugar and changes it into galactose and glucose. When person who suffers from lactase deficiency they experience diarrhea and abdominal cramping after consuming products containing milk and lactose.
Lactose: This is the sugar found in milk products. In the body this is broken down by the enzyme lactase into glucose and galactose.
Lactose intolerence: When a person suffers from lactose intolerence, they do not have enough enzyme lactase to break down the sugar lactose that is found in milk products. Often results in cramping, diarrhea and flatulence.
Vitamin D: This can be normally absorbed through adequate sun exposure as vitamin d synthesis is promoted in the skin from the sunlight. Vitamin D is a vitamin that helps with metabolism of phosphorus and calcium, and intestinal absorption. Vitamin D deficiency can result in bone weakness or Osteomalacia in adults and bone deformity or known as rickets in children. Lack of Vitamin D can be supplemented with Vitamin D capsules that can be taken orally. A must have for someone who is on a lactose intolerence diet.
Yogurt: This is made when Lactobacillus or milk bacillus is fermented with curdled milk. Great as a snack for a lactose intolerence diet.