Lactose intolerance is the inability to completely digest lactose, the predominant sugar found in milk. If lactose is not absorbed properly, it ferments and this results in bloating, cramps, gas, flatulence, and diarrhoea amongst others. Lactose intolerance affects more than half of the world population. It may also the cause of baby colic. According to various studies, lactose intolerance accounts to more than half of wrongly diagnosed patients with irritable bowel syndrome (IBS). Lactose intolerance is the most common form of food intolerance; others include carbohydrate, fructose, and gluten. Lactose Intolerance can also be a side effect of gluten Intolerance. It can be treated with Lactase supplements (available in the Products section). Lactose intolerance must not be confused with milk allergy, of which comparison details are listed below.
What causes lactose intolerance?
Milk contains lactose, a disaccharide made of two sugars joined together. Our body is not able to absorb lactose unless it is broken down into two sugars. So to get around this lactase present in the lining of the small intestine splits lactose so it could be absorbed. The figure on the right shows lactose (top) broken down into two sugars by means of the lactase (centre) into glucose and galactose (bottom) two absorbable sugars.
If there is insufficient lactase, or nothing at all, lactose remains in the digestive system. This is fermented by the bacteria living in the large intestine resulting in excess gas, stomach rumbling and bloating. Severe intolerance leads to diarrhoea and other symptoms.
Who can get lactose intolerance?
Lactase activity is normally high in babies, although baby colic may be caused by temporarily lactase deficiency (see baby colic). After the ages of 5-6 lactase production starts decreasing in many individuals but the rate varies from one person to another and also between races. From the table below one can conclude that the majority of people in the world are lactose intolerant.
|Lactose Intolerance Around the World|
% Lactose Intolerance
However there are other people irrelevant of what race or age they are that may develop lactose intolerance:
- Coeliac disease: this condition causes damage to the lining of the small intestine hence lactase is not produced
- Small intestine surgery: may become unable to produce lactase anymore
- Antibiotic treatment: may cause diarrhoea which damages lining of the small intestine temporarily reducing lactase production. Treatment can be accelerated with probiotics containing life bacteria
What are the symptoms?
Lactose left in our digestive system causes extraction of fluids (water) from the body into the guts (same as when drinking sea water) by a process called osmosis. The combination of fluids and lactose in the digestive system is an attractive combination for the bacteria living in the large intestine that will digest lactose producing gases associated with flatulence.
The symptoms are:
- Abdominal pain - cramps
- Bloating - caused by the formation of gases
- Flatulence - caused by the gases produced by the bacteria
- Diarrhoea - loose stools
- Borborygmi - may be audible to the patient and on physical examination
- Weight loss - if kept unattended
- Malnutrition - especially in babies
How can I avoid the symptoms?
One may work out how much milk/dairy can be tolerated before the symptoms kick in. This can, however, be tricky because most processed food contains hidden lactose. Abstaining from milk and dairy is a better solution but this can almost be impossible.
The best treatment to avoid the symptoms is by supplements of lactase enzymes. There are many commercially available lactase enzymes, but the best by far is Prolactazyme Forte that when tested at foodreactions.org proved to be the most effective and reliable product. It continues to work for several hours after intake and unlike many others the body never gets used to it. It is fully derived from plants and also suitable for vegans. This is now available world wide from foodreactions.org. Buy Prolactazyme Forte now>>>
There is also lactase enzyme in the form of liquid. This is handy to turn normal milk into lactose free saving you a lot of money. It is suitable for babies to avoid baby colic and ideal for those who like to drink milk or putting milk with cereals, tea or coffee for the breakfast etc. This is now also available at FoodReactions.org. See the Products section for today's offers.
How can I test for lactose intolerance?
The most common tests used to measure the absorption of lactose in the digestive system are the lactose tolerance blood test, the hydrogen breath test, and the stool acidity test performed on babies. These tests are performed on an outpatient basis at a hospital, clinic, or doctor's office. However, one can do a home self-test in which after fasting for 12 hours a person drinks a large glass of milk taking nothing else for the next 3-5 hours. If symptoms develop one can be certain he/she has lactose intolerance.
lactose intolerance is not milk allergy.
Lactose intolerance must not be confused with milk allergy. Milk allergy is caused when our immune system thinks proteins found in milk are harmful, hence an immune response is triggered causing symptoms related to food allergy, such as rash, hives, swelling etc. However, some symptoms such as vomiting and diarrhoea can be common for both so it is important to read and understand the difference for better diagnosis.
|Lactose Intolerance & Milk Allergy Comparison|
|Cause||not enough enzymes to breakdown the sugars, such as lactose consumed in foods.||immune system thinks that some proteins in foods (such as milk) are of those of harmful bacteria, hence, an immune response is triggered.|
|Age||starts later in childhood but most common in adults, may be temporarily present in the form of colic in babies.||starts usually from early infancy and more common in children who overgrow it, triggered in later adult life in some who never had it in childhood.|
affect the digestive system only:
Some may experience vomiting. The magnitude of the above symptoms are inversely related to the amount of enzyme produced. Some people can produce less than others.
usually immediate and affecting more that one part of the body-
digestion: nausea, vomiting, stomach cramps and diarrhoea
skin: swelling eczema, hives
airways: wheezing, coughing, congestion and a runny nose
anaphylaxis: most known to happen in peanuts allergy but can be triggered by all sorts of food ingestion.