Lactose is a type of sugar (carbohydrate) found in milk and in dairy products made from milk products such as yoghurt, ice-cream, and cheese. Lactose is made of two simple sugars called ‘glucose’ and ‘galactose’. Sometimes lactose is added to processed foods as an ingredient.
What is lactose intolerance?
Lactose intolerance is the inability to digest and absorb lactose in the small intestine due to insufficient production of the enzyme lactase. In healthy people, the body produces enough lactase to break down the lactose into glucose and galactose. The body can then absorb the glucose and galactose and uses them for energy. If there is not enough lactase, the lactose is partially fermented by the bacteria in the intestines, which causes flatulence (excessive wind or gas) bloating and abdominal pain. The remaining undigested lactose continues along the intestinal tract retaining water along the way and resulting in diarrhoea.
Symptoms of lactose intolerance
The symptoms of lactose intolerance include:
• Abdominal bloating
• Flatulence (excessive wind / gas)
• Abdominal cramps
• Abdominal pain
• Failure to thrive or slow growth in children
Symptoms usually often occur 30 minutes to 2 hours after you eat or drink lactose-containing products and are usually dose dependent, that is, larger amounts of ingested lactose generally cause more severe symptoms.
Levels of the lactase enzyme produced vary between individuals, as does the severity of symptoms of lactose intolerance. Some people are more sensitive and suffer severe symptoms after consuming only small amounts of lactose. Some may tolerate small amounts of lactose whereas other may tolerate larger amounts of lactose if intake is spread out over the day.
What causes lactose intolerance?
Lactose intolerance is largely genetically determined. Babies are born with adequate levels of lactase to be able to digest breast milk. However, in those people with genetic predisposition to lactose intolerance, the level of the lactase enzyme decreases over time during childhood and early adulthood. This genetically programmed decrease in lactase eventually leads to lactose intolerance.
This type of lactose intolerance is more common in people with Asian, African, Middle Eastern, Native American, Australian Aboriginal or Mediterranean ancestry than it is among northern and western Europeans. There also is variability in the age at which symptoms of this type of lactose intolerance appear.
Congenital lactose intolerance
Congenital lactose intolerance is where a person is born with a complete absence of the lactase enzyme. This is a rare condition caused by a mutation in the gene that is responsible for producing lactase. Symptoms of congenital lactose intolerance begin shortly after birth but should not be confused with temporary lactose intolerance that may occur in premature babies.
Lactose intolerance caused by other illness
Some diseases, illnesses or medical procedures can damage the lining of the small intestine and reduce the amounts of the lactase enzyme. This can result in secondary lactose intolerance in people who could previously digest lactose.
Common causes of secondary lactose intolerance include:
• Gastroenteritis or infections in the small intestine from other viruses, bacteria or parasites, which can temporarily reduce lactase levels. This type of lactose intolerance usually resolves itself after a few weeks.
• Intestinal diseases such as celiac sprue
• Bowel surgery
• Iron deficiency, which can interfere with lactose digestion and absorption.
Diagnosis of lactose intolerance
Methods used to help diagnose lactose intolerance include:
• Hydrogen breath test
• Elimination diet
• Stool pH test
Your General Practitioner, Dietitian or Gastroenterologist can recommend the most suitable diagnostic method based on your medical history and presentation.
Treatment of lactose intolerance
The treatment for lactose intolerance is the exclusion of lactose containing foods. Symptoms of lactose intolerance resolve once lactose intake is eliminated.
The lactose content of dairy foods varies widely as do individuals’ tolerance to lactose. Reducing lactose intake often involves reducing or eliminating dairy from the diet, which may lead to deficiencies of calcium. It is important to ensure that the remainder of the diet provides adequate nutrition and alternative sources of calcium need to be considered if dairy is completely eliminated.
You could feel better with a Lactose Free diet
Lactose Intolerance affects approximately 10% of Australians. If you have any of the digestive symptoms listed above, you could feel much better with a low lactose or lactose free diet. I can help you structure a suitable diet plan to ensure adequate nutrition while testing how much lactose you can tolerate and which foods need to be excluded to resolve your symptoms and have you feeling better again.
Manage your Lactose Intolerance and feel better with a Lactose Free diet
Make an appointment for a private nutrition consultation today:
Sydney Essential Health, Woollahra / Bondi Junction: (02) 9389 6955
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