Summary about Disease
Lactase deficiency (also known as lactose intolerance) is a condition where the body doesn't produce enough lactase, an enzyme needed to digest lactose. Lactose is a sugar found in milk and other dairy products. This deficiency results in the undigested lactose moving into the colon, where it is fermented by bacteria, causing gas, bloating, and diarrhea. Lactase deficiency is not the same as a milk allergy.
Symptoms
Symptoms of lactose intolerance typically begin 30 minutes to two hours after consuming dairy products. Common symptoms include:
Diarrhea
Nausea, and sometimes, vomiting
Abdominal cramps
Bloating
Gas The severity of symptoms varies depending on the amount of lactose consumed and the amount of lactase produced by the individual.
Causes
The most common cause of lactase deficiency is a genetic predisposition to decreased lactase production over time. This is known as primary lactase deficiency and is common in adults of certain ethnic backgrounds (e.g., Asian, African, Hispanic). Other causes include:
Secondary lactase deficiency: This occurs when the small intestine is damaged by illness, surgery, or injury (e.g., Crohn's disease, celiac disease, gastroenteritis).
Congenital lactase deficiency: A rare genetic disorder where infants are born with very little or no lactase.
Developmental lactase deficiency: This occurs in premature infants, whose small intestines may not be fully developed.
Medicine Used
There isn't a cure for lactase deficiency, but its symptoms can be managed. Common approaches include:
Lactase enzyme supplements: These are available over-the-counter and are taken before consuming dairy products to help digest lactose. Common brands include Lactaid or Dairy Ease.
Calcium and Vitamin D Supplements: People who reduce or eliminate dairy from their diet might need to take these supplements to meet nutritional requirements.
Is Communicable
Lactase deficiency is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
The primary precautions involve dietary management:
Limit dairy intake: Experiment to determine the amount of lactose you can tolerate.
Choose lactose-reduced products: Opt for milk, yogurt, and cheese that have reduced lactose content.
Read food labels carefully: Lactose can be found in unexpected products like bread, salad dressings, and processed foods.
Take lactase supplements: Take these before consuming dairy to aid digestion.
Gradual Introduction: Try introducing small amounts of dairy to potentially increase tolerance over time.
How long does an outbreak last?
Lactase deficiency isn't an "outbreak" disease like an infection. Symptoms typically last for the duration that undigested lactose is present in the digestive system and being fermented by bacteria in the colon. This is generally a few hours after consuming lactose-containing foods.
How is it diagnosed?
Diagnosis typically involves one or more of the following tests:
Lactose tolerance test: After drinking a liquid containing lactose, blood glucose levels are measured. A significant rise in glucose indicates proper lactose digestion.
Hydrogen breath test: Measures the amount of hydrogen in your breath after consuming lactose. Elevated hydrogen levels suggest lactose intolerance, as undigested lactose produces hydrogen gas in the colon.
Stool acidity test: Used primarily in infants and children, this test measures the acidity of the stool. Undigested lactose leads to increased acidity.
Intestinal biopsy: In rare cases, a biopsy of the small intestine may be performed to measure lactase levels directly.
Timeline of Symptoms
The onset of symptoms typically occurs within a range of 30 minutes to 2 hours after consuming lactose-containing foods or beverages. The duration of symptoms can vary depending on the amount of lactose ingested and individual sensitivity, but symptoms generally subside within a few hours as the undigested lactose is processed in the colon.
Important Considerations
Calcium Intake: Ensure adequate calcium intake from non-dairy sources (e.g., leafy green vegetables, fortified foods, supplements) or lactose-free/reduced dairy products.
Not a Milk Allergy: Lactase deficiency (lactose intolerance) is different from a milk allergy. A milk allergy involves an immune system reaction to milk proteins, which can be more severe and even life-threatening.
Individual Variability: Lactose tolerance varies widely. Some people can tolerate small amounts of lactose, while others experience symptoms with even trace amounts.
Secondary Causes: Consider the possibility of secondary lactase deficiency if symptoms develop suddenly or are accompanied by other digestive issues. It is recommended to consult a healthcare professional for proper diagnosis and management.
Examine all Medications and Supplements: Lactose is sometimes used as a filler in medications and supplements. Review labels carefully if you are very sensitive to lactose.