Lactose intolerance

Lactose intolerance is a digestive disorder characterized by the body's inability to fully digest lactose, a sugar found in milk and dairy products. Individuals with lactose intolerance experience symptoms such as bloating, diarrhoea, and abdominal pain after consuming lactose-containing foods. This condition is prevalent worldwide, with varying degrees of severity among affected individuals.

Overview

Definition:

Malabsorption of Lactose: Lactose intolerance results from a deficiency of lactase, the enzyme responsible for breaking down lactose into simpler sugars that can be absorbed by the small intestine.

Prevalence:

Global Impact: Lactose intolerance is common, affecting a significant portion of the global population. Rates of lactose intolerance vary by ethnicity and geographical region.

Degrees of Severity:

Lactase Non-persistence: Many individuals with lactose intolerance have a genetic predisposition known as lactase non-persistence, where the production of lactase decreases after childhood.

Causes and Risk Factors

Genetic Factors:

Lactase Gene Expression: Genetic factors play a crucial role, with some populations having a higher prevalence of lactase non-persistence.

Age-related:

Primary Lactose Intolerance: The most common form occurs as individuals age, and the production of lactase decreases naturally.

Secondary Causes:

Gastrointestinal Disorders: Conditions such as celiac disease, Crohn's disease, and infections can lead to secondary lactose intolerance.

Symptoms

Gastrointestinal Distress: Symptoms typically occur within 30 minutes to two hours after consuming lactose-containing foods and may include bloating, diarrhoea, abdominal pain, and flatulence.

Diagnosis

Hydrogen Breath Test:

Lactose Tolerance Test: A hydrogen breath test measures the amount of hydrogen in the breath after consuming a lactose-containing solution.

Stool Acidity Test:

Stool Acidity Test: This test is commonly used in infants and young children. Undigested lactose in the stool causes increased acidity.

Elimination Diet:

Elimination Diet: Temporarily removing lactose-containing foods from the diet and then reintroducing them can help identify the cause of symptoms.

Management and Treatment

Dietary Modification:

Lactose-free Diet: Individuals with lactose intolerance often manage symptoms by avoiding or limiting dairy products. Lactose-free alternatives are available.

Lactase Supplements:

Lactase Enzyme Supplements: These supplements can be taken with meals to help digest lactose.

Gradual Introduction:

Gradual Introduction of Dairy: Some individuals can tolerate small amounts of lactose, and gradual reintroduction may be possible.

Complications

Nutritional Deficiencies: Long-term avoidance of dairy products may lead to deficiencies in calcium and vitamin D, impacting bone health.

Cultural and Dietary Considerations

Cultural Variation: Lactose intolerance is more prevalent in some ethnic groups, and cultural dietary practices often adapt to accommodate this condition.