Manage Lactose Intolerance
Milk and other dairy products contain a sugar or carbohydrate called lactose. Normally, the body breaks down lactose into its simpler components with the help of the enzyme lactase. Most mammals stop producing lactase when they are weaned; humans, however, continue to produce it throughout life. Without enough lactase, a person can have digestive problems like abdominal pain and diarrhea. This is known as lactose intolerance or lactase deficiency.
The level of lactase enzyme in the body varies between individuals, and a deficiency of the enzyme leads to the symptoms of lactose intolerance. When this happens lactose is left undigested in the gut, which is then broken down by bacterial activity, producing lactic acid and hydrogen gas and resulting in discomfort, bloating and wind or flatulence.
Why do people get lactose intolerance?
Lactose intolerance develops when the body has a deficient supply of the enzyme lactase. This can arise for several reasons:
• Lactose intolerance can be hereditary so that certain races and geographical areas are more likely to have the condition.
• Transient lactase deficiency is a common condition in babies resulting from an immature digestive system at birth. This has been shown to be an important factor in some babies with colic and generally corrects itself by about 4 months of age.
• Our bodies are designed to produce the lactase enzyme in response to the lactose in breast milk. In some people the production of lactase decreases as they get older, which can lead to a gradual increase in the symptoms of lactose intolerance in adults.
• Lactose intolerance can arise from various gut or digestive disorders, which may be temporary.
Symptoms of lactose intolerance
Many people with lactose intolerance have a particular tolerance level, which allows them to consume some lactose with minimal symptoms. Symptoms of lactose intolerance include:
• Abdominal pain
• Abdominal swelling
Symptoms of lactose intolerance are often confused with symptoms of irritable bowel syndrome (IBS). People with IBS are not lactose intolerant, but tend to have difficulty tolerating fat. If you think you may be lactose intolerant, see your doctor.
Undigested milk sugars
The enzyme lactase breaks down milk sugar (lactose). Lactase enzymes are found in the mucus of the small intestine. They change the milk sugar into the absorbable compounds - glucose and galactose.
If there is not enough lactase, it skips the usual digestive process and is partially broken down by the bacteria in the intestines. This fermentation process causes excessive wind, bloating and associated pain. Any undigested lactose is sent along the intestinal tract. Water is not removed from the faecal matter and diarrhoea is the result.
Causes of lactose intolerance
Lactose intolerance is largely genetically determined. Some causes include:
• Congenital - this is the main cause, where your genetic make up causes you to have less lactase than usual.
• Gastroenteritis - this can strip the intestines of lactase for a few weeks.
• Parasitic infection - this can temporarily reduce lactase levels.
• Iron deficiency - lack of iron in the diet can interfere with lactose digestion and absorption.
Lactose intolerance in babies
Lactose intolerance in newborns of normal birth weight and in babies is rare. But if your child has symptoms of lactose intolerance, see your doctor right away. Diarrhea is very dangerous because it can lead to dehydration, a serious problem that requires immediate attention.
Babies who are only fed breast milk do not develop lactose intolerance, because breast milk contains lactase, the enzyme that helps digest milk sugar. If your baby is formula-fed and develops lactose intolerance, you can switch to a formula made without lactose. In rare cases, a baby may have a reaction to the proteins in milk, which is a different condition called sensitivity to milk protein.
Ways to manage lactose Intolerance
Most people with lactose intolerance can handle small amounts of lactose, such as a glass of milk. However, the following tips may help:
• Try cheese and yoghurt; they are generally better tolerated than milk.
• Drink full-fat milk because the fats slow the journey of the milk through the intestines and allow the lactase enzymes more time to break down the sugars.
• Avoid low-fat or non-fat milks - they travel quickly through the gut and tend to cause symptoms in lactose intolerant people. Also, many low-fat milk products may contain skim milk powder, which provides a higher dose of lactose.
• Don’t give up milk products entirely. They are very nutritious.
• Drink milk in moderate quantities. Most people with this condition can tolerate 240ml of milk per day, but you need to work out your own tolerance level. You can buy milk that has had the lactose broken down, which makes it lactose free.
• Eat fermented milk products like some yoghurts, mature or ripened cheeses (like cheddar, fetta and mozzarella), and butter - they usually don’t cause problems.
• Eat foods that contain lactose in combination with other foods or spread them out over the day, rather than eating a large amount at once.
• Use heated milk products like evaporated milk; they seem to be better tolerated because the heating process breaks down some of the lactose to glucose and galactose.
• Have soy foods; they are lactose free, a good source of calcium and a good substitute for milk or milk products.
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