Description of lactose intolerance
Lactose intolerance is a partial or complete inability of the digestive tract to process lactose – a milk sugar. The human digestive tract is not able to absorb lactose, but can be split into smaller sections and then further used. The cause of the inability to process lactose is the lack of an enzyme – lactase, the lactose Stipe. Uncleaved and unabsorbed sugar is then superfluous in the intestine, gets to other parts of the gastrointestinal tract where it there present bacteria begin to ferment.
At present, he affects approximately every sixth member of the population, while southern nations and the black algae is its frequency much higher than the inhabitants of northern Europe. The frequency of lactose intolerance increases markedly with age, in preschool children is rare, but in old age suffer from it most of the population.
Lactose intolerance, we must not be confused with cow’s milk allergy. Even though they have a common denominator, namely adverse reactions after consumption of milk, it is a different disease, mainly in the mechanism of origin. Lactose intolerance is an enzymatic disorder, whereas cow’s milk allergy is against the protein contained in milk, forming specific antibodies. Symptoms of both of these diseases, however, are quite similar.
Risk factors lactose intolerance
Lactase in the small intestine may be missing from various causes. It is a rare congenital deficiency of lactase, which take effect immediately after birth. The only solution is for him Lactose diet.
In premature neonates because of the immaturity of the gastrointestinal tract may also exhibit this disease. Therefore, preterm infants are fed by special milk with a reduced lactose content, and in most cases with organ systems vyzráním problem adjusted.
The most common cause of lactase deficiency is genetically conditioned by decreasing the production of this enzyme. It’s called adult, that adult type lactose intolerance. With increasing age, the normal production of lactase decreases, and it begins to exert just milk intolerance.
It happens that damage the lining of the intestine to other influences cause the emergence of lactose intolerance – it is then called secondary or acquired. It arises as a consequence of many infectious diarrheal diseases, after use of certain drugs (antibiotics), and also some chronic bowel diseases such as Crohn’s disease or celiac disease. Typically occurs in children in infancy after infectious diarrhea caused by rotavirus, which after attempts to reintroduce dairy into the diet of a child appear lengthy diarrhea. Lack of the enzyme is only temporary, the healing of the intestinal mucosal surface begins to form again, and then the child can drink milk without any other negative consequences.
Preventing disease lactose intolerance
The genetic influence decreased production of lactase can not, therefore, prevention against the disease exists. When the diagnosis of celiac disease must follow a prescribed diet.
Symptoms of lactose intolerance
Undigested lactose is superfluous in the intestine. Intestine seeks its contents diluted, therefore inside the lumen begins to penetrate large amount of water, which causes the increase in volume of intestinal contents, as reflected by accelerating peristalsis and diarrhea occurs. In addition, the lactose in the colon is the food for the bacteria that it will begin to ferment. This produces many products – hydrogen, gases such as methane and carbon dioxide, and organic acids, which irritate the intestinal wall, causing cramp and pain. Hydrogen is absorbed and is exhaled through the lungs, which is used in the diagnosis of disease.
The consequence of insufficient processing then lactose is sour smelling diarrhea occurring in response to the consumption of milk (30 minutes to 12 hours), further distension, collywobbles and pouring the contents of the intestines. Diarrhea is usually accompanied by increased flatulence.
In some patients, especially infants, it is not a typical symptom of diarrhea, abdominal pain but, the subsequent rejection of food and inadequate child gain weight.
Treatment of lactose intolerance
Suspected lactose intolerance is usually confirmed by a hydrogen breath test. During fermentation of the milk sugar is formed in a larger quantity of hydrogen which is absorbed in the intestine and exhaled by the lungs. The test was thus carried out by determining the amount of hydrogen in expired air after administration of lactose.
Another variant confirmation of the diagnosis is determining the pH of the liquid stool that is when lactose intolerance acidic, due to the higher content of organic acids.
The doctor may also measure blood glucose (blood sugar) after administration of lactose, which is the case with lactose intolerance slightly increased. It occurs due to the undigested lactose into simpler sugars that are absorbed from the intestine and blood glucose would increase.
The least used test, mainly due to its complexity and invasive character is a direct determination of the enzyme in the intestinal mucosa. Doctor endoscopically cuts a small piece of small intestinal mucosa and it then indicates the presence or absence of lactase.
The disease can be treated only by limiting the lactose in the diet, only in exceptional cases it is necessary to products containing lactose completely excluded. Since most affected has in fact still in its intestine least little activity lactase has no trouble after consumption of small amounts of products containing lactose.
Some dairy products have already naturally low in lactose, are especially hard and ripened cheeses. You can even patients with lactose intolerance to consume virtually unlimited.
Sometimes even the milk well tolerated, particularly when mixed with cocoa or corn flakes, which increase the yield of food, it causes slow digestion and lactose has a higher chance to be digested remnants of an enzyme found in the intestine.
Also dairy products with a higher proportion of fat, such as cream or cream and, in smaller quantities may not cause the patient any major difficulties.
Yoghurts and sour products namely lactose include, but include bacteria that with its help digestion in the intestine, and so their consumption, the majority of people with lactose intolerance no trouble. “Friendly” bacteria that are found in probiotics, may also be the patient’s condition suffering from lactose intolerance significantly improved.
It is necessary to pay attention to other foods that may contain lactose. These include milk chocolate, desserts, ice cream, cakes, butter, margarine, or foods containing milk powder. Lactose is also found in a number of drugs in drinks, even in chewing gum. It is therefore necessary to monitor the composition of the foods that we eat.
There are also special lactose-free milk and lactose-free dairy products, or you can take the tablets containing lactase, which are available in pharmacies without a prescription.
How can I help myself
When excluding the milk from the diet is necessary to supplement the calcium in other foods,consumption of which should be increased. Most of calcium (in mg / 100 g diet) contains poppy seeds, followed by heating and hard cheese, buckwheat, including Lenovo and sunflower seeds, beans, nuts, broccoli and chives. It is also possible intake of calcium in the body increased with supplements.
Complications of lactose intolerance
Persistent prolonged diarrhea after ingestion of milk, particularly in young children, can lead to the development of dehydration.
Lack of calcium in the body, which can occur with prolonged discontinuation of milk and dairy products and other ingredients nedoplňování calcium supplements can also be dangerous. Show up after a while, and joint pain, increased tooth decay, rickets, muscle cramps, brittle nails, loss of sensation in the extremities, as well as memory loss and depression.
Other names: Lactose maldigestion, lactose intolerance