Lactose intolerance is the inability to digest lactose due to the inability of the intestinal cells to produce the enzyme lactase or if present it is present in inadequate concentration. The enzyme lactase breaks down lactose into two sugars glucose and galactose.
Lactose intolerance may be primary, secondary or due to congenital. The primary lactose intolerance is due to normal ageing process. The secondary lactose intolerance is due to some gastrointestinal diseases like parasite infection, for example giardia. In patients of parasitic gastrointestinal infection there is permanent impairment of lactase production. In cases of lactose overload and gastritis caused due to rotavirus infection the lactase production is temporarily affected.
Congenital lactose intolerance is due to deficiency of the enzyme lactase which prevents enzymatic production of lactase.
Lactose intolerance develops at different ages in different populations. It can begin at any age in an individual’s life.
Lactose intolerance can be diagnosed by ingestion of more dairy product than the quantity readily digested. If symptoms develop in half an hour to two hours after consumption of milk or dairy products then it is a case of lactose intolerance.
Enteroscopy and test for stool reducing substances may be done. Hydrogen breath test, stool acidity test and intestinal biopsy are he tests used to confirm the diagnosis.
The condition lactose intolerance is considered to be the one that does not require any treatment. The condition can be managed by four principles viz:-
Avoiding lactose containing foods
Intake of substituted food items to maintain nutritional requirements
Regulation of enzyme intake and
Use of enzyme substitutes.
Alternative milk products may be used. They are: lactose free milk and milk products, lactase treated cow milk, soya or rice milk for toddlers, soya products of children younger than two years, butter milk and cheese, fermented milk products like yogurt, ice creams, milkshakes, aged or hard cheese and goat’s milk.
Symptoms disappear once milk and milk products are withdrawn from the diet.
Lactose intolerance does not have any threat to a person’s life. These societies do have equivalent health status and sometimes better than the lactose tolerating societies. It is important to balance the nutrition gained from dairy products from some other foods.
