Lactose Intolerance

Lactose intolerance is a condition wherein an individual presents with digestive symptoms such as bloating, diarrhoea and gas after intake of foods or drinks that are rich in lactose. Lactose is a kind of sugar often found in milk and dairy products like cheese, ice cream, and other products.

This condition is also called Lactose malabsorption. It is usually harmless, but the symptoms experienced by the individual can be uncomfortable. This condition runs in families and affects people of all age groups, including children and adults. Lactose intolerance occurs when the body's small intestine doesn't produce an adequate amount of a digestive enzyme called Lactase.

The main aim of Lactase is to break down the lactose in the food so that it gets absorbed by the body.

Types of Lactose Intolerance

Following are the various types of lactose intolerance:

• Primary lactose intolerance: This is the most common form of lactose intolerance seen among individuals and is caused by a decrease in the production of Lactase with age. As a result, individuals lose the ability to absorb lactose in their bodies over time.
  This form of lactose intolerance may be genetic to some extent since it is more commonly noticed in some populations than others.
• Secondary lactose intolerance: This form of lactose intolerance occurs due to some other condition that targets the small intestine, where Lactase is produced. This is because the inflammation in the gut wall leads to a temporary decline in lactase production. Possible causes of secondary lactose intolerance include
  • Crohn's disease
  • Ageing
  • Chemotherapy
  • Celiac diseases
  • Ulcerative colitis
• Congenital lactose intolerance: This form of lactose intolerance is a lifelong condition and is present among newborn babies. This is a rare, inherited condition in which both parents must possess the gene mutation for congenital lactose intolerance required for the infant to be born with this.
  These infants cannot breastfeed due to the presence of lactose content in breast milk, and this condition may even prove fatal if not detected early. Side effects may include severe diarrhoea and high calcium levels.
• Developmental lactose intolerance: This lactose intolerance occurs in infants, too and is typically noticed in premature babies. They are born before their digestive system is fully developed and functional, and it causes symptoms like digestive distress.
  This condition typically settles slowly on its own as the baby grows, but meanwhile, the infant requires lactose-free formula rather than breast milk.

Lactose Intolerance Symptoms

The various signs and symptoms of lactose intolerance usually occur from half an hour to 2 hours after consuming foods rich in lactose. The most commonly seen signs and symptoms are as follows:

• Nausea
• Pain in the abdomen
• Bloating
• Diarrhoea
• Gas
• Growling sounds in the stomach
• Vomiting
• Stomach cramps
• Flatulence

Lactose Intolerance Diagnosis

Following tests can help the doctor to detect lactose intolerance. These comprise of:

• Lactose Tolerance Test: This test checks the absorption of lactose by the digestive system. The patient is asked to remain on an empty stomach and not to consume or drink anything for about 8 hours before the test. During the test, the patient is made to drink a liquid which contains lactose. Some blood samples will be taken over 2 hours. These will detect the blood sugar (blood glucose) level. If these levels don't rise, patients may be lactose intolerant.
• Hydrogen Breath Test: The patient is made to drink a liquid containing an adequate amount of lactose, and afterwards, his breath will be checked several times. High levels of hydrogen in the breath indicate that the patient is lactose intolerant.
• Stool Acidity Test: This test is used for infants and young children and depicts the amount of acid in the stool. If any individual is not digesting lactose, their stool will have traces of lactic acid, glucose, and other fatty acids.

Lactose Intolerance Treatment

Ideally, the treatment of this condition depends on the cause of lactose intolerance. However, for congenital lactase deficiency, no such treatment is required. If any injury is caused to the small intestine, the doctors treat the underlying cause of the injury. In the case of developmental lactose intolerance, the condition resolves on its own, and no specific alteration in the diet is required.

In other cases, the amount of discomfort caused due to lactose intolerance can be controlled by following a low-lactose diet. These include:

• Consumption of lactose-reduced milk or ice cream
• Limitation of other dairy products
• Addition of powder lactase enzyme in the milk for the breakdown of lactose

Maintainance of excellent and healthy nutrition is essential among patients with lactose intolerance. The intake of the following things can achieve it:

• Cereals
• Juices
• Oranges
• Broccoli and green vegetables
• Salmon
• Nuts and Almonds

Probiotics can be administered as supplements, either in capsule form or even yoghurt, for various gastrointestinal conditions like Diarrhoea and Inflammatory Bowel Syndrome. These also help in the digestion of lactose.

Lactose Intolerance Risk factors

Factors responsible for making children more prone to lactose intolerance include:

• Increasing Age: Lactose intolerance usually appears in adulthood and is uncommon in babies and young children.
• Ethnicity: Lactose intolerance is often seen in people of African, Asian, Hispanic and American Indian descent.
• Premature Birth: In premature infants, there are low levels of Lactase because of the fact that the small intestine doesn't develop lactase-producing cells. They only do so late in the third trimester.
• Diseases Targeting the Small Intestine: Minor intestine diseases leading to lactose intolerance comprise bacterial overgrowth, celiac disease and Crohn's disease.
• Certain Cancer Treatments: If the patient has undergone radiation therapy for cancer in the stomach region or in case of intestinal complications from chemotherapy, the risk of developing lactose intolerance increases.

Outlook

Lactose intolerance generally includes a common set of symptoms caused by a deficiency in Lactase. These symptoms appear after the consumption of foods rich in lactose. Individuals remain concerned about the limitations regarding milk and dairy product intake. However, there are plenty of food and beverages and few treatment options to cure these symptoms and enjoy a healthy life. 

Reviewed & Updated On

Reviewed by Dr. Sanjay Dhall, Director, Internal Medicine on 18-July-2023.

Related Blogs

• What to Eat in Loose Motion - Do's and Dont's
• Flatulence
• Gastric Problem Causes, Symptoms & Treatment
• How Good is Soya Milk and Other Milk Available in Market
• Recurrent Abdominal Pain in Children: What a Parent Needs to Know
• Chronic Abdominal Pain in Children