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Lactose Intolerance


What Is It?

 

Lactose intolerance (also known as lactose malabsorption or lactase deficiency) is the name given to the condition in which the body is unable to digest lactose (milk sugar). Put another way, the body cannot break down lactose into its component sugars—glucose and galactose. Normally, this breakdown is performed by the enzyme lactase, which is manufactured in the lining of the small intestine. Lactase, however, is absent or deficient in the intestines of lactose intolerant people making it difficult for them to handle milk and other dairy products.

It is important to note that lactose intolerance is not the same as a milk allergy, which is an immune response to one or more of the components in the milk, usually a protein. Poor protein digestion is believed to play a role in allergies because the immune response is triggered to react to the presence of unfamiliar undigested proteins in the gut lining or in the bloodstream. The person who is allergic to milk products, however, is not necessarily lactose intolerant since lactose intolerance is a function of poor enzyme activity and not an allergic reaction. 

What Causes It?

There are three main types of lactose intolerance, which are summed up well by the Colorado State University: (read more)

• Primary lactose intolerance – the most common form in which lactase gene expression turns off in childhood, and the individual is relatively lactase-deficient as a teenager and adult.

• Secondary lactose intolerance – a number of diseases affecting the small intestine (inflammatory conditions, bacterial, viral or parasitic infections) can result in temporary lactase deficiency in individuals that are normally lactose tolerant. In most cases, this deficiency resolves in a few weeks.

• Congenital lactase deficiency – rare disorder in which lactase is deficient from birth.

Lactose intolerance normally occurs in adults, though it may less frequently affect children. It can occur in infants after a severe bout of gastroenteritis which damages the intestinal lining.

People who are intolerant to the lactose in milk may likewise be sensitive to sugar alcohols such as sorbitol, maltitol and xylitol; and should check labels for the presence of these substances.

When lactose is not thoroughly broken down in the small intestine for any of the reasons discussed, all or some of it enters the colon intact. That portion of unsplit lactose that reaches the large intestine serves as food for bacteria residing there. As these bacteria feed upon the undigested milk sugar, gases and irritating acids are produced giving rise to unpleasant symptoms.

Lactose intolerance affects up to 75 percent of the world’s population. It is especially prevalent among people of Asian, African, Native American, Mexican and Mediterranean ancestry, affecting an estimated 70 to 90 percent of people within these groups. Least affected (10 to 15 percent) are people of Northern or Western European ancestry. An estimated 50 million Americans are lactose intolerant.

People with Crohn’s disease (an inflammatory bowel disease) and celiac disease (gluten sensitivity) are often lactose intolerant due to damage of the intestinal lining from the disease processes that interfere with lactase production.

What Are the Signs and Symptoms?

Within a short time—usually 30 minutes to two hours—of ingesting milk or dairy products, the lactose intolerant person will develop mild to severe symptoms that may include: (read more)

• Abdominal cramps

• Gas and bloating

• Diarrhea

• Nausea

• Headaches

• Acne

The onset of gastrointestinal symptoms may follow the ingestion of even small amounts of lactose, although individual tolerances to the milk sugar vary greatly. Some people are affected by the presence of minute amounts while others are able to tolerate a glass or two of milk. Some people may have a lactase deficiency and yet be without symptoms. They would not be considered lactose intolerant.

Lactose intolerance can be caused by gut inflammation. If symptoms of lactose intolerance become severe, it can cause leaky gut and lead to other problems in the body. Although lactose intolerance is rare in infants, when it occurs the following symptoms may appear: foamy diarrhea with diaper rash, slow weight gain and development, and vomiting.

Some dairy products tend to cause more problems than others. Ice cream is often especially difficult for people with lactose intolerance to handle because some manufacturers add extra lactose to enhance its texture. Hard, aged cheeses such as Parmesan, on the other hand, are relatively low in lactose, and so are generally easier to handle. Fermented dairy products, such as yogurt (with live, active cultures), are usually well tolerated by people with lactose intolerance, as these products have been predigested by bacteria so that most of the lactose is broken down.

 


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The symptoms of lactose intolerance—gas and bloating, abdominal cramping, loose stools or diarrhea—are also symptoms of a few different digestive conditions. Be sure that your symptoms are not actually the result of one of these conditions. (See the Rule Out list below.)

If you do determine that your symptoms are only the result of eating dairy, then this condition is easy to manage. 

There is a spectrum of severity in people with lactose intolerance. Some people react to even the smallest amount of lactose. Other people can eat certain diary products in moderation, but develop symptoms when they overindulge. Determine where on this spectrum you are. From there, you can experiment with taking a lactose-digesting enzyme formula which will help to digest any lactose that you eat. Dosage will vary depending on where you are on the spectrum. 

This condition can be easy to manage, but paying attention to your symptoms and making the appropriate changes accordingly is important because, if not controlled, gut imbalance can develop.

Rule Out:

Food sensitivity

Candida overgrowth

• Parasitic infection

• Irritable bowel syndrome, IBS

• Inflammatory bowel disease, IBD

Diet

• If there is increased inflammation in the digestive tract, a three-day juice fast would be helpful.

• After that, follow the Skinny Gut Diet Eating Plan.

• Some people can tolerate hard cheeses like parmesan, and yogurt because they are relatively low in lactose.

• Eat plenty of foods high in calcium like: black strap molasses, apricots, broccoli, collard greens, kale, spinach, salmon and sardines.

Lifestyle

• Read product labels carefully. In addition to milk and milk solids, you must be aware of the dairy ingredients in processed foods.

Complementary Mind/Body Therapies

• Acupuncture could be helpful during an episode of lactose intolerance.

• Colon hydrotherapy is recommended for lactose intolerance.