Lactose intolerance: symptoms, diagnosis, and treatment
About the symptom
Lactose intolerance is a condition in which the body is unable to digest lactose, a sugar found in milk and dairy products. This occurs due to a deficiency in the enzyme lactase, which is necessary for breaking down lactose into simpler sugars – glucose and galactose. When lactose is not digested, it reaches the large intestine, where it starts to ferment, causing various unpleasant symptoms.
Clinical manifestations of lactose intolerance can vary depending on the level of lactase deficiency and the amount of dairy product consumed. The most common symptoms include bloating, gas, diarrhea, and painful cramps. These symptoms usually occur 30 minutes to 2 hours after consuming foods that contain lactose. It is important not to ignore these signs, as they can significantly affect the quality of life, causing discomfort and complicating dietary choices.
Diseases
Lactose intolerance, while quite a common condition, may be associated with a number of diseases and disorders that affect the body’s ability to digest dairy products. First and foremost, it may be a result of a deficiency in the active enzyme lactase, which is responsible for breaking down lactose – the milk sugar. Low levels of lactase may be caused by hereditary factors, which is relevant for many ethnic groups, or can develop as a result of damage to the intestinal mucosa due to infections, inflammatory diseases, or other factors.
Additionally, chronic diseases such as celiac disease or Crohn’s disease can lead to temporary or permanent lactose intolerance. In these conditions, inflammatory processes in the intestines may disrupt lactase production, leading to symptoms similar to those observed in patients with primary intolerance. Individuals with chronic diseases are often subject to changes in the gastrointestinal tract, so it is important to carefully monitor their diet and undergo examinations when necessary.
- Celiac disease
- Crohn’s disease
- Ileitis
- Infectious gastrointestinal diseases
- Chronic pancreatitis
- Irritable bowel syndrome
- Atopic diseases (in some cases)
Diagnosis
The diagnosis of lactose intolerance plays a key role in establishing an accurate diagnosis and prescribing appropriate treatment. The main diagnostic methods are specialized tests that allow determining the level of lactose intolerance in the patient. The doctor may prescribe a hydrogen breath test, which helps identify an increase in hydrogen levels in the breath after consuming lactose-containing products. This is because undigested lactose is fermented by bacteria in the intestines, leading to the release of hydrogen.
Another common method is a stool acidity test, especially in children. This test helps determine whether undigested lactose is present in the stool, which is an indicator of intolerance. Genetic tests may also be prescribed to identify a predisposition to lactose deficiency. Comprehensive diagnosis allows doctors to correctly assess the situation and offer patients the most effective recommendations and dietary changes.
- Hydrogen breath test
- Stool acidity test
- Genetic testing
- Intestinal biopsy (in rare cases)
- Clinical interview and symptom assessment
Which doctor to consult
Lactose intolerance can cause a number of unpleasant symptoms that negatively affect the quality of life of the patient. Therefore, it is extremely important to correctly identify which specialist to consult for the diagnosis and treatment of this condition. Usually, the first doctor that people suspecting lactose intolerance consult is a therapist. This specialist will conduct an initial examination, collect medical history, and, if necessary, refer to narrow specialists.
In case of suspicion of lactose intolerance, it is also advisable to visit a gastroenterologist. This doctor specializes in diseases of the digestive system and can conduct additional tests to confirm the diagnosis. Moreover, if you have associated digestive problems or allergies, you may need a consultation with an allergist or a dietitian who can help develop an individual diet excluding dairy products.
- Therapist
- Gastroenterologist
- Allergist
- Dietitian
- Endocrinologist
Types of lactose intolerance
Lactose intolerance, also known as lactase deficiency, is a condition in which the body cannot effectively digest lactose – a carbohydrate found in dairy products. There are several types of lactose intolerance, which can vary in terms of the causes and the severity of the symptoms. The main types include primary, secondary, and congenital lactose intolerance.
Primary lactose intolerance is the most common form and usually develops with age, when the level of the enzyme lactase, responsible for digesting lactose, begins to decrease. Secondary intolerance can occur as a result of intestinal damage due to intestinal infections, inflammatory diseases, or other conditions affecting the digestive organs. Congenital lactose intolerance, although extremely rare, occurs immediately after birth and is associated with genetic factors that cause a lack of lactase from the first days of life.
- Primary lactose intolerance
- Secondary lactose intolerance
- Congenital lactose intolerance
Causes of Lactose Intolerance
Lactose intolerance is a condition that arises due to a deficiency of the enzyme lactase, which is necessary for breaking down lactose, the sugar found in dairy products. This can be related to both genetic factors and acquired disorders. The primary cause is genetic predisposition, where the level of lactase decreases with age, leading to a reduced ability of the body to digest dairy products after reaching a certain age.
However, lactose intolerance can also develop after diseases of the small intestine, such as celiac disease or infectious gastroenteritis, which damage the mucosa and can lead to temporary loss of lactase function. Other factors that may contribute to the development of this condition include autoimmune diseases and specific diets low in dairy products, which result in a decrease in the body’s natural adaptation to digesting lactose.
- Genetic predisposition
- Intestinal issues (celiac disease, gastroenteritis)
- Age-related changes
- Poor nutrition
- Autoimmune diseases
Common Related Pathologies
Lactose intolerance is a condition that is often accompanied by various diseases and pathologies. People suffering from this problem may develop a range of comorbid conditions related to digestive system disorders. For example, chronic gastritis and irritable bowel syndrome may worsen with the consumption of lactose-containing products. This is explained by the peculiarities of the intestinal function, which cannot effectively process milk sugar.
Additionally, individuals with lactose intolerance may experience allergies, such as eczema and asthma, due to constant irritation of the intestines or dysbiosis that may arise as a result of microbiota disturbances. Studies show that there is a direct link between lactose intolerance and various skin disorders, as intestinal problems can manifest on the skin.
- Chronic gastritis
- Irritable bowel syndrome
- Eczema
- Asthma
- Intestinal dysbiosis
- Pancreatitis
- Nutrient absorption disorders
Expert Opinion
Lactose intolerance is a common disorder that affects many people around the world. According to leading gastroenterologists, this issue is not limited to just food indigestion. Understanding the mechanisms of lactose intolerance and following the right diet can significantly improve the quality of life for patients. Experts emphasize that some individuals need to completely eliminate lactose-containing products, while others can consume them in moderate amounts.
Experts highlight that it is important not only to avoid dairy products but also to find substitutes that provide the necessary amount of calcium and vitamins. It is also crucial to remember that the symptoms of lactose intolerance can overlap with the manifestations of other diseases, so a proper medical examination and consultation with a doctor are necessary steps for accurate diagnosis and treatment. Lactose intolerance should be seen not as a sentence but as a signal for adjusting dietary habits and increasing awareness of one’s health.
Treatment of Lactose Intolerance
The treatment of lactose intolerance primarily involves changing the diet and eliminating foods that contain lactose. There are various degrees of intolerance, and an individual approach is recommended for each patient. In some cases, complete elimination of lactose-containing products may not be necessary: many people can tolerate small amounts of lactose without significant discomfort. Therefore, it is important to pay attention to a personalized approach to the diet.
In addition to dietary changes, there are other methods for managing lactose intolerance. Doctors may recommend taking special enzyme supplements that contain lactase, which help digest lactose. These supplements can be taken before meals that contain lactose and help prevent unpleasant symptoms. It is also worth noting that in some cases, lactose intolerance may be associated with other diseases, so it is important to carefully assess health conditions and undergo additional examinations if necessary.
Main treatment methods:
- Adhering to a low-lactose diet
- Using enzyme supplements that contain lactase
- Consultations with a dietitian to create a balanced diet
- Additional examinations to rule out comorbidities
Complications
Lactose intolerance can lead to a number of complications that can significantly worsen a person’s quality of life. Primarily, complications arise due to insufficient processing of lactose, which can cause chronic digestive disorders, such as diarrhea, abdominal pain, and bloating. These symptoms can lead to the avoidance of lactose-containing products, which in turn may result in a deficiency of important nutrients, such as calcium and vitamin D, which are essential for bone health and overall well-being.
Moreover, uncontrolled lactose intolerance can lead to emotional discomfort and social isolation. People suffering from this condition may avoid social events where high-lactose foods are offered or where they cannot control their diet. This can lead to various psychological issues, including anxiety and depression. Therefore, it is important to take measures to manage symptoms and seek professional advice and recommendations for proper nutrition.
- Chronic digestive disorders
- Nutrient deficiencies (calcium, vitamin D)
- Emotional disorders (antisocial behavior, anxiety, depression)
- Increased burden on the intestines
FAQ
How to find out if I have lactose intolerance?
To determine if you have lactose intolerance, consult a doctor for specialized tests such as a hydrogen breath test or a blood lactose level test. These methods will help assess how your body handles lactose. Additionally, keeping a food diary and monitoring symptoms after consuming dairy products can also provide useful information about the presence of intolerance.
What amount of lactose is considered safe for people with intolerance?
The amount of lactose that is considered safe for people with intolerance can vary depending on individual sensitivity. Many people with a mild form of intolerance can tolerate 6-12 grams of lactose at a time without symptoms appearing. This corresponds to a small amount of dairy products, such as ½ cup of milk. However, those with a more severe form of intolerance may need to completely eliminate lactose from their diet. It is recommended to keep a food diary and gradually test portions to determine what specific dosage is suitable for the individual, as well as to consult with a doctor or dietitian for personalized recommendations.
Is it possible to take the enzyme lactase to improve digestion with lactose intolerance?
Yes, the intake of lactase enzyme can significantly improve digestion in people with lactose intolerance. Lactase helps to break down lactose found in dairy products into simpler sugars — glucose and galactose, which are easier to absorb. Taking lactase before consuming dairy products can reduce symptoms such as bloating, cramps, and diarrhea, allowing many people to enjoy their favorite dairy products without fear of unpleasant consequences. However, it is advisable to consult a doctor before starting to take any enzymes to determine appropriate dosages and receive personalized recommendations.
What are the main products that contain lactose, and should they be avoided in case of intolerance?
With lactose intolerance, it is important to know which products contain this carbohydrate to avoid unpleasant symptoms. The main products that contain lactose include milk and dairy products such as yogurt, cheese, cream, ice cream, and whole milk. In addition, lactose may be present in some processed foods, such as baked goods, ready-made sauces, and certain types of bread. People with lactose intolerance are advised to avoid or limit the consumption of these products; however, some of them may contain low amounts of lactose and be tolerably tolerable. It is important to read labels carefully and choose alternatives, such as lactose-free milk and plant-based beverages like soy or almond milk.