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Lactose Intolerance: Causes, Symptoms, Diagnosis, and Management
Introduction
Lactose intolerance is a common digestive disorder in which the body is unable to properly digest lactose, a sugar found in milk and other dairy products. This condition occurs due to a deficiency of lactase, an enzyme produced in the small intestine that breaks down lactose into simpler sugars (glucose and galactose) for absorption. When lactose isn't digested, it ferments in the colon, causing gastrointestinal symptoms.
Causes of Lactose Intolerance
There are several types of lactose intolerance, each with different causes:
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Primary Lactose Intolerance
- This is the most common type, often developing naturally with age.
- Lactase production decreases after childhood in many people, especially among African, Asian, Native American, and Hispanic populations.
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Secondary Lactose Intolerance
- Caused by illness or injury to the small intestine.
- Conditions like gastroenteritis, celiac disease, Crohn’s disease, or chemotherapy can damage the lining of the gut, reducing lactase production.
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Congenital Lactose Intolerance
- A rare genetic disorder where babies are born without any lactase enzyme.
- It is inherited in an autosomal recessive pattern and typically appears soon after birth.
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Developmental Lactose Intolerance
- Seen in premature infants whose small intestines are not fully developed to produce enough lactase.
Symptoms
Symptoms typically begin 30 minutes to 2 hours after consuming lactose-containing foods or drinks. Common signs include:
- Bloating
- Abdominal cramps
- Diarrhea
- Gas (flatulence)
- Nausea (sometimes with vomiting)
The severity of symptoms varies depending on the amount of lactose consumed and the individual’s tolerance level.
Diagnosis
Diagnosing lactose intolerance involves a combination of history-taking, symptom analysis, and diagnostic tests:
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Lactose Tolerance Test
- After drinking a lactose solution, blood sugar levels are measured. If levels don’t rise, it suggests lactose isn’t being digested.
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Hydrogen Breath Test
- Measures hydrogen in the breath after lactose consumption. High levels indicate fermentation by bacteria due to undigested lactose.
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Stool Acidity Test
- Used mainly for infants and young children. Undigested lactose produces lactic acid, which can be detected in stool samples.
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Elimination Diet
- Removing lactose-containing foods and observing whether symptoms improve.
Management and Treatment
There is no cure for lactose intolerance, but symptoms can be effectively managed through dietary and lifestyle adjustments:
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Dietary Modification
- Limit or avoid milk and dairy products.
- Use lactose-free or low-lactose alternatives (e.g., almond, soy, oat milk).
- Choose lactose-free dairy products or hard cheeses like cheddar and parmesan, which have lower lactose content.
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Lactase Enzyme Supplements
- Taken before consuming dairy to help digest lactose.
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Calcium and Vitamin D
- Essential nutrients found in dairy must be obtained from other sources like leafy greens, fortified cereals, or supplements.
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Read Food Labels
- Lactose can be hidden in processed foods such as baked goods, salad dressings, and instant soups.
Prognosis
Lactose intolerance is not life-threatening and can be well-managed. Many people live normal lives by making informed dietary choices and understanding their body’s tolerance levels.
Conclusion
Lactose intolerance is a manageable condition that affects millions globally. Understanding the causes, recognizing the symptoms, and adopting appropriate dietary habits are key to living comfortably with this condition. With increasing availability of lactose-free alternatives and growing awareness, individuals can maintain a nutritious and satisfying diet without discomfort.
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