Lactose Intolerance

General Illness Information

Common Name:
Lactose Intolerance

Medical Term: None Specified

Description: Diarrhea and abdominal distention caused by inability to digest carbohydrates because of a lack of one or more intestinal enzymes. The commonest variant is a lack of lactase, which is required to digest lactose in cow’s milk. If lactose is not digested, it remains in the intestine, and causes diarrhea and abdominal distension.

Causes: Deficiency or absence of the enzyme lactase which is necessary to digest all milk except mother’s milk. Although some infants are born with the disorder, lactose intolerance usually develops later on in life. Lactase deficiency occurs normally to some degree in about 75 % of North American adults.

Prevention: Lactase deficiency cannot be prevented. The symptoms can be readily prevented.

Signs & Symptoms

In children, it causes diarrhea, occasional vomiting, delayed weight gain, growth and development.

In adults:

  • Abdominal cramps and diarrhea.
  • Gas and bloating.
  • Nausea.
  • Inability to tolerate milk and milk products.
  • Intolerance to dairy foods.

Risk Factors

  • Family history of lactase enzyme deficiency.
  • Temporary lactase deficiency may be caused by acute diarrheal states.

Diagnosis & Treatment

The diagnosis may be suspected when chronic or intermittent diarrhea is acidic (pH < 6). Other tests to confirm the diagnosis include lactose breath hydrogen test, lactose absorption test and rarely, small bowel biopsy.

General Measures:

  • A lactose free diet is the mainstay of treatment.
  • Calcium and vitamin D supplements may be given.
  • Over the counter supplements are available. These neutralize lactose in milk (e.g. lactaid). Special lactose free dairy products are available.

Medications:

No medications are necessary.

Activity:

No activity restriction.

Diet:

  • If the condition is present at birth, an infant formula that contains little or no lactose, such as a soybean-based formula or lactose-free milk formula.
  • If lactose intolerance is temporary and is caused by a severe bout of gastroenteritis, substitute formula (lactose-free or soybean formula) may be used. This usually resolves in 3-4 weeks and cows milk may be introduced again.
  • Older persons with lactose intolerance should restrict dairy products. Milk treated with special enzyme called lactase may be better tolerated.
  • Yogurt and hard cheese are better tolerated than milk.
  • Read labels on food products. Milk-sugar is used in many prepared foods and may cause symptoms.

Possible Complications:

Calcium deficiency (rare).

Prognosis

Symptoms are readily controlled. There is no effect on life span. There is no cure as such.

Other

‘Nothing Specified’.

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