Lactose Intolerance: Causes, Symptoms, Diagnosis, and Treatment

Lactose intolerance is the body’s inability to digest lactose. Lactose is a natural sugar found in milk and all processed products of cows. This is caused by insufficient production of the enzyme lactase in the body, an enzyme produced in the small intestine – which is needed to digest lactose. Although lactose intolerance is not dangerous, the symptoms can be disturbing to the patient.

Types and Causes of Lactose Intolerance

There are three types of lactose intolerance, and all have different causes. Here are some types and causes of lactose intolerance:

1. Primary Lactose Intolerance

Is the most common type of lactose intolerance. People who experience primary lactose intolerance start producing large amounts of lactase, a necessity for babies who need all the nutrients from milk.

When children start switching from milk or consuming other foods, lactase production usually decreases, but is high enough to digest milk for adults.

Lactase production falls sharply in people who have primary lactose intolerance, making milk-based foods difficult to digest as adults. Primary lactose intolerance is genetically affected, occurring in most people of African, Asian or Hispanic descent. This type of intolerance is also common among people of Mediterranean or Southern European descent.

2. Secondary Lactose Intolerance

This type of lactose intolerance occurs when the small intestine reduces lactase production due to illness, injury or small bowel surgery. Diseases associated with secondary lactose intolerance are celiac disease, bacterial overgrowth, and Crohn’s disease.

Treatment of the underlying disorder can restore lactase levels and improve signs and symptoms, although this takes time.

3. Congenital lactose intolerance

Although this type of lactose intolerance is rare, infants with lactose intolerance are caused by the absence of lactase activity. This disorder is passed down from generation to generation in a pattern called recessive autosomes, which means that the mother and father must inherit the same gene variant so that the child is affected.

Premature babies may also have lactose intolerance because of insufficient levels of lactase.

Risk Factors for Lactose Intolerance

Some factors that can make a person more susceptible to lactose intolerance are:

1. Increasing age

Lactose intolerance usually occurs in adulthood. But this condition rarely occurs in infants and young children.

2. Ethnicity

Lactose intolerance is most common in people of African, Asian, Hispanic and American Indian descent.

3. Premature Birth

Premature babies have decreased levels of lactase because the small intestine does not develop lactase-producing cells until the end of the third trimester.

4. Small intestine disease

Problems with the small intestine can cause lactose intolerance, including bacterial overgrowth, celiac disease, and Crohn’s disease.

5. Certain Cancer Treatments

If you have undergone radiation therapy for cancer in the stomach or have bowel complications due to chemotherapy, the risk of lactose intolerance is increased.

Symptoms of Lactose Intolerance

The level of lactose intolerance varies depending on the amount of lactase enzymes that the body can produce. Therefore, there are some people who can still eat foods with a small amount of lactose, but there are also some people who have to avoid them altogether.

The main features of lactose intolerance are:

  • Nausea and vomiting
  • Cramps and abdominal pain
  • Stomach full of gas
  • Bloated
  • Diarrhea

Symptoms of lactose intolerance usually last 30 minutes to 2 hours after drinking milk products or processed cow’s milk. The severity of symptoms varies, depending on the amount of lactose a person drinks or eats and how lactose tolerance is on his body.

Some people are sensitive to only a small amount of food containing lactose, while others are able to eat a lot of food containing lactose before symptoms appear.

Diagnosis of Lactose Intolerance

The doctor will diagnose by paying attention to the characteristics of lactose intolerance and the response when reducing the amount of food containing milk. The doctor can confirm the diagnosis of lactose intolerance by doing one or more of the following tests:

1. Lactose Tolerance Test

This test can measure the body’s reaction to liquids that contain high levels of lactose. Two hours after drinking the liquid, you will have a blood test to measure the amount of glucose in the bloodstream. If glucose levels do not rise, the sign is the body does not digest and absorb drinks containing lactose properly.

2. Hydrogen Breath Test

This one test also requires you to drink liquids that contain high levels of lactose. Then the doctor periodically measures the amount of hydrogen in the breath. Generally, very little hydrogen is detected. However, if the body does not digest lactose, the liquid will ferment in the large intestine, releasing hydrogen and other gases that are absorbed by the intestine and finally exhaled.

The amount of hydrogen that is greater than the normal amount measured during a breath test shows that you are not fully digesting and absorbing lactose properly.

3. Stool Samples

Lactose tolerance tests and hydrogen breath tests are not suitable for infants, so stool testing can be done. High levels of acetate and other fatty acids in stool can indicate lactose intolerance.

4. Underlying Disease or Condition

If the symptoms of lactose intolerance can be caused by an underlying condition, such as celiac disease.

Complications of Lactose Intolerance

Milk and other dairy products contain calcium, protein and vitamins, such as A, B12 and D. Lactose also helps the body absorb a number of other minerals, such as magnesium and zinc.

These vitamins and minerals are important for the development of strong and healthy bones. If it is intolerant of lactose, it is difficult for you to get the right amount of essential vitamins and minerals.

This condition can lead to unhealthy weight loss and a higher risk of developing the following conditions:

  • Osteopenia: Where the body has very low bone mineral density. If left untreated, it can develop into osteoporosis.
  • Osteoporosis: This condition makes the bones thin and weak, and the risk of having broken bones.
  • Malnutrition: When the food you eat does not provide essential nutrients for the body that functions for health. This condition makes healing the wound in the body take longer and may feel tired or depressed.

If you are concerned about the risk of complications due to lactose intolerance, you should consult with a nutritionist, to get advice about diet and whether food supplements are needed.

Natural Lactose Intolerance Treatment

If you don’t want to stop drinking milk or milk-based products, here are some ways to overcome lactose intolerance:

1. Enzyme Supplements

This supplement can help digest lactose. Enzyme supplements in the form of tablets that are swallowed or dropped on food and drinks.

However, the response of enzyme supplements varies from person to person. However, lactase enzyme supplements may be very effective for some people.

2. Lactose Exposure

If you are lactose intolerant, adding lactose regularly to your food can help the body adapt.

3. Probiotics and Prebiotics

How to deal with lactose intolerance next time taking probiotics. Probiotics are microorganisms that are beneficial to health. Prebiotics are a type of fiber that functions as food for beneficial bacteria that are already owned in the intestine, so they can develop.

Alternative Foods to Substitute Milk

Dairy products are a source of calcium, protein, vitamin A, vitamin B12, and vitamin D. Avoiding milk because lactose intolerance can cause nutritional deficiencies, unless replaced with foods with similar nutritional content. Here are alternative food sources to replace milk:

1. Calcium

Seaweed, nuts and seeds, oranges, quinoa, spinach, collard greens, okra, broccoli, dandelion leaves, kale, and enriched products such as orange juice and vegetable milk.

3. Vitamin A

This one vitamin you can get from carrots, broccoli, sweet potatoes, cod liver oil, liver, spinach, peas, eggs, apricots, pumpkins, melons, papayas, and mangoes.

4. Vitamin D

Vitamin D levels can be increased by basking in the sun, eating fatty fish, eggs, fish liver oil, and fortified vegetable milk.

5. Lactose-Free Milk

People who have symptoms of severe lactose intolerance should check food product labels to ensure that lactose levels are zero. Instead, you can consume vegetable-based milk that contains less protein than cow’s milk.

According to Nutrition Australia, most people with lactose intolerance do not have to avoid all dairy products. Even people who have low lactase levels can usually tolerate up to 12 grams of lactose a day or one cup of milk.

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