Some people are forced to give up dairy products not because of taste preferences, but due to the deterioration of their condition after consuming them. Milk intolerance in children and adults is considered by some to be a type of allergy, but this is not always the case. The problem is much more common. Symptoms of the disorder are variable; Some experience excessive gas formation and intestinal disorders, while others may even experience transient mental disorders.
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In our country, the prevalence of pathology in the population is over 15%.
The main sugar in natural milk is lactose.
Normally, it is broken down in the digestive tract into monosaccharides galactose and glucose under the action of the enzyme lactase-phlorizin hydrolase. Only simple sugars can be absorbed into the systemic circulation, and undigested lactose entering the colon becomes an ideal breeding ground for bacteria. The process of lactic acid fermentation begins with the formation of water and a large amount of gas (CO2).
If there is a lack of lactase, 30-40 minutes after consuming dairy products (including homemade cheese and ice cream), intestinal dysfunction develops. Possible in the abdominal area, and. The severity of clinical symptoms depends on the degree of enzyme deficiency and the amount of milk consumed.
If lactase deficiency is minor, problems may not arise. People with enzyme deficiency do not have to completely give up dairy foods; they just need to limit the amount in their diet. If hypersensitivity to milk components is nevertheless detected, you should avoid taking even a small amount of the product in order to avoid the development of allergic reactions in the form of skin rash, bronchospasm, angioedema, and in severe cases -
Causes of milk intolerance
Lactase deficiency can be primary or acquired.
Primary alactasia of newborns is a consequence of genetic mutations.
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Pathology is more often detected among people belonging to the Mongoloid race.
Secondary enzyme deficiency can develop against the background of many somatic diseases.
Diseases that provoke hypolactasia include:
- granulomatous enteritis ();
- viral origin;
- amyloidosis;
- bacterial intestinal infections;
- (systemic pathology with damage to the small intestine).
Even the lactase biosynthesis process can have a negative effect on the cells of the small intestine. The cause of acquired enzyme deficiency can be operations on the gastrointestinal tract.
Secondary lactase deficiency often disappears with clinical recovery or the onset of stable remission. In most cases, with this disorder, the patient is able to consume a small amount of milk without complications.
Normally, a child's enzyme production begins to decline after stopping breastfeeding or starting complementary feeding. Lactase levels decrease markedly by 2-3 years of age. In older children and adults, the degree of lactose tolerance is determined by the individual characteristics of the body.
Symptoms of milk intolerance in children and adults
In case of individual hypersensitivity to milk (allergy) due to its consumption, an immediate hypersensitivity reaction develops.
Allergy symptoms:
The severity of clinical manifestations of lactase deficiency depends on the type of pathology (primary or acquired) and the level of enzyme deficiency.
With primary alactasia, 1-2 hours after feeding, the baby appears:
- (watery, foamy stool);
- rumbling in the intestines;
- (pains of a cramping nature).
Subsequent feedings worsen the baby's condition; signs of dehydration develop, weight decreases, and tachycardia appears. The condition is seriously life-threatening.
In adults, the symptoms are much less pronounced, since we are more often talking about hypolactasia, i.e., partial lack of an enzyme. Malaise usually appears after drinking a significant amount of milk - over 200-300 ml. Intestinal spasms, flatulence and diarrhea develop. Extraintestinal symptoms include general weakness, and.
Diagnostics
As a rule, diagnosing lactase deficiency does not present any particular difficulties for a gastroenterologist. The appearance of symptoms is clearly associated with the intake of milk, and its exclusion from the diet helps to quickly normalize the condition.
In doubtful cases, it is necessary to study lactase activity in tissue samples from the wall of the small intestine. The material is obtained during endoscopy.
To verify the diagnosis, additional blood is taken for genetic testing and determination of the level of galactose in the serum.
How to treat milk intolerance?
The fight against lactase deficiency involves eliminating foods containing lactose from the diet, or reducing their consumption. Drug therapy is of secondary importance.
Elimination diet therapy
Genetically determined alactasia requires a complete and lifelong abstinence from milk in any form. Children diagnosed with this pathology are transferred to artificial feeding with special lactose-free formulas from the first days of life. If hypolactasia is detected, the use of low-lactose formulations is allowed.
Formulas for infants with alactasia must be marked “FL” or “BL”.
Some products contain so-called. hidden sources of milk sugar. People with hypolactasia should be careful when consuming baked goods, freeze-dried mashed potatoes, many pastries, white sauces, and prepared condiments. Before including semi-finished products in your diet, you must carefully read their composition.
Many stores now sell special lactose-free milk, which is not inferior to natural milk in its taste and nutritional properties. It should not be confused with acidophilus or low fat!
For patients with hypolactasia, it is advisable to experimentally establish a dose of milk that is safe for them. Many people can afford to drink 200 ml 1-2 times a week in several doses. In some cases, lactose tolerance increases with a gradual increase in the volume of its consumption. Some people with lactase deficiency tolerate fermented milk products quite well. and cheeses are characterized by a relatively low content of milk sugar, but very high nutritional value.
People who are unable to consume enough dairy products are more likely to develop calcium deficiency. A deficiency of this macroelement can lead to structural disorders in bone tissue - and osteomalacia. To prevent such complications, you need to eat more foods rich in calcium and.
These include:
- canned fish with softened bones;
- legumes;
- soy cheese;
- beef and pork liver;
- chicken eggs;
- cabbage (white, cauliflower and broccoli);
- turnip;
- almond;
- leafy greens.
Drug therapy
Currently, a number of pharmacological agents have been developed, the main active component of which is lactase. Some should be added directly to milk, while others should be taken separately, but simultaneously with dairy products.
With timely detection of milk intolerance and strict adherence to the rules of elimination diet therapy, the prognosis is quite favorable.
If acquired hypolactasia occurs, rational comprehensive treatment of the underlying disease is of great importance. Patients may need to consult an allergist, immunologist and infectious disease specialist.
Plisov Vladimir, doctor, medical observer
Lactose is one of the complex sugars found in milk and all dairy products. During the digestive process, lactose is broken down by lactase (an enzyme secreted in the small intestine) into simple sugars (monosaccharides and galactose), which are absorbed into the bloodstream. " Intolerance" refers to the inability to digest lactose, often associated with lactase enzyme deficiency. About 30 minutes after consuming milk or dairy products such as ice cream or cottage cheese and cottage cheese, people with lactose intolerance may experience diarrhea (diarrhea) or cramping (stomach cramps) and bloating (increased gas in the intestines). the severity of which depends on the level of enzyme deficiency. However, a person with a mild enzyme deficiency may not experience any symptoms at all.
It is widely believed that lactose intolerance it's for milk. In fact, this is not the case, and the difference between these two concepts is very great. People with lactose intolerance do not necessarily need to remove milk and dairy products from their diet, but they do need to control the amount of dairy products they consume. But people suffering from milk allergies should not consume even minimal amounts of milk. Symptoms of a milk allergy include difficulty breathing, a tight throat, nasal discharge, swollen eyes and eyelids, skin rashes, etc. Lactose intolerance manifests itself differently.
Causes of lactose intolerance
Congenital lactase enzyme deficiency, common mainly among people belonging to the Asian race.
A natural decrease in lactase levels, which begins in childhood (after 3 years). How significant this reduction will be depends on the characteristics of the individual person’s body. However, it is safe to say that the older a person is, the more likely it is that he suffers from lactose intolerance.
Any disease that affects the cells of the small intestine that produce lactase, such as inflammatory diseases and even. This condition causes " secondary lactase deficiency" This is a temporary problem that disappears as soon as the disease passes and the damaged cells are restored and begin to produce enzymes again.
Surgery on the stomach and intestines, which can completely destroy the body's ability to produce lactase.
Symptoms of lactose intolerance
- diarrhea, loose stools;
- increased gas formation;
- abdominal cramps.
What can you do
Find out your degree lactose intolerance. Besides monitoring your body's reaction to milk and dairy products, there are two accurate ways to test for lactose intolerance:
- oral tolerance test;
- hydrogen breath test (involves measuring the level of hydrogen in exhaled air, which depends on the amount of undigested lactose).
Try eating foods with reduced amounts of lactose or no lactose at all. You should not completely deprive yourself of dairy products containing lactose, because... Not only does this dramatically reduce the amount of calcium in your diet, it also reduces your body's ability to absorb calcium from non-dairy foods (since lactose helps your intestines absorb and retain calcium).
Keep in mind that skim milk is not safer because it has less fat. The problem of intolerance is not related to fat content, but to lactose. Buttermilk and acidophilus milk also contain lactose, so you should be careful with them too.
Try yogurt. Many people suffering from lactose intolerance, can normally digest the lactose contained in yogurt. Yogurt is an excellent source of calcium. Use trial and error to determine which type of yogurt you tolerate best. Avoid pasteurized yogurts as... the benefits from them are much less, and the harm from lactose remains.
Drink chocolate milk. Calcium from such milk is perfectly absorbed, and the chocolate taste makes it more pleasant. Moreover, cocoa can even stimulate lactase activity.
Some cheeses, especially cheddar, parmesan, Swiss cheese and mozzarella, are excellent sources of calcium. However, they are not dangerous from the point of view of lactose, because Whey, which contains the most lactose, is separated during the cheese making process. But cottage cheese, homemade cheese and ricotta are rich in lactose, so they should not be abused.
Drink milk with meals or with cereal products. Taking lactose with food makes it easier to digest and causes fewer side effects.
Drink milk in small portions (half a cup) several times a day with meals. This will replenish the required dose of calcium and will not cause any special problems.
Be careful and watch what you eat. Lactose can be found in bread, frozen vegetables, canned soups, salad dressings and sauces, spaghetti, etc., breakfast cereals, cakes, candy and even pharmaceutical products.
Watch closely for signs lactose intolerance. If you have this problem, there is a very high chance that your children will have it too. In infants, congenital lactose intolerance can be life-threatening. As soon as a lactose intolerant baby is fed breast milk or formula containing milk, he or she develops colic, gas, and stops gaining weight. Today, special artificial nutrition that does not contain lactose is available. Contact your pediatrician who will select artificial nutrition and a balanced diet for your child that will help replenish the required amount of calcium in his diet.
However, some simple precautions can help people with mild lactase intolerance avoid unpleasant symptoms without completely depriving themselves of milk and dairy products.
If you are lactose intolerant, do not completely deprive yourself of dairy products. Try eating calcium-rich foods such as milk, but in small doses (less than a cup) and drink it with meals. In general, cheese and yogurt in small quantities are quite easily tolerated by people with lactose intolerance.
You can also try lactose-free milk, cheese and cottage cheese or other sources of calcium, such as soy milk, almonds, broccoli and other green vegetables, fish, etc.
Lactose intolerance is the inability to digest lactose, which is the main sugar found in milk and dairy products. Lactose intolerance is caused by the complete absence or deficiency of lactase, an enzyme necessary to break down lactose in the small intestine. This condition is not life-threatening, but can cause stomach upset and intestinal discomfort (bloating, pain, flatulence) and limit food choices. Many adults are lactose intolerant but have no other medical conditions. However, remember that some diseases can cause gastrointestinal problems, so it is important to distinguish the symptoms of these diseases from the symptoms of lactose intolerance.
Steps
Symptoms of lactose intolerance
- If you have bloating and gas after both meals, you likely have a stomach or intestinal condition (such as inflammatory bowel disease or Crohn's disease).
- If you feel fine after both meals, there is a chance that you have a food allergy or intolerance to another food.
- This method is usually called an elimination diet: you eliminate dairy products from your diet to determine which substances cause the reaction.
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Distinguish between lactose intolerance and milk allergy. Lactose intolerance is a disease caused by a lack of enzymes that causes undigested sugar (lactose) to accumulate in the large intestine. Once it is there, the bacteria living in the intestines begin to consume the sugar and produce hydrogen and some methane, which causes bloating and flatulence. A milk allergy is an abnormal reaction of the immune system to dairy products. Most often it occurs in the first minutes of contact with casein or whey. Symptoms of a milk allergy include wheezing, severe rash, swelling of the lips, mouth and throat, runny nose, watery eyes, vomiting and problems digesting food.
- Cow's milk allergy is one of the most common allergies among children.
- Typically, cow's milk causes the reaction, but goat's milk, sheep's milk, and the milk of other mammals can also cause allergies.
- Adults with hay fever or food allergies to other foods are more likely to have an adverse reaction to milk.
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Find out how lactose intolerance is linked to ethnicity. Although there is less lactase in the small intestine as we age, the amount of lactase is also related to genetics. Lactose intolerance is much more common in some ethnic groups. For example, about 90% of Asians and 80% of African Americans and Native Americans have this feature. Lactose intolerance is least common among Northern European peoples. If you belong to an ethnic group at increased risk of this condition and experience discomfort after eating, there is a high chance that you have lactose intolerance.
- Lactose intolerance is rare in infants and young children of all ethnicities. This problem usually appears in later life.
- However, in babies born prematurely, the ability to produce lactase may be reduced because the gastrointestinal tract is not yet fully formed.
Diagnosis confirmation
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Pass a hydrogen breath test. This is the most common way to determine lactose intolerance. This test is performed in a hospital or health center, but is usually ordered only after you have tried eliminating milk from your diet. You will be asked to drink a small amount of lactose (25 grams) and then the doctor will measure the amount of hydrogen in your breath several times (every 30 minutes). A person whose body can break down lactose will produce little or no hydrogen. If a person is lactose intolerant, there will be much more hydrogen, since sugar is fermented in the intestines with the participation of bacteria that produce this gas.
- This is a convenient way to diagnose intolerance and gives accurate results.
- You will have to avoid smoking and eating in the morning for a while.
- If a person consumes too much lactose, the result may be false positive due to the large number of bacteria in the intestines.
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Take a blood test for glucose and lactose. The test assesses the body's response to the consumption of large amounts of lactose (usually 50 grams). First, fasting blood glucose levels are measured, and then 1–2 hours after consuming lactose. If your blood sugar doesn't rise 20 grams per deciliter above your fasting level, it means your body can't digest and absorb lactose.
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Get your stool tested for acidity. Undigested lactose forms lactic acid and other fatty acids in the intestines, which pass into the stool. A stool acid test is usually prescribed for young children and can detect acid in the stool. The child is given a small amount of lactose and then tested several times in succession. A young child may also have glucose in their stool because the lactose has not been digested.
- This test is suitable for children who are unable to undergo other tests to diagnose lactose intolerance.
- Although this test is effective, breathalyzer testing is more commonly used because it is simpler and more convenient.
Pay attention to gastrointestinal symptoms. As with other illnesses, it can be difficult to know if what you're feeling is unusual. For example, if a person always feels discomfort after eating, he considers this his normal state, and it seems to him that everything is exactly the same for everyone. However, bloating, flatulence, colic, nausea or diarrhea after eating are not the norm - all these symptoms indicate problems with the gastrointestinal tract. Many gastrointestinal diseases have similar symptoms, so making a diagnosis can sometimes be difficult. The first step is to recognize that what you feel after eating is not normal and that it can be prevented.
Try to analyze the relationship between your symptoms and the consumption of dairy products. The main symptoms of lactose intolerance (bloating, abdominal pain, flatulence, diarrhea) usually appear 30-120 minutes after eating or drinking lactose-containing drinks. Therefore, you should try to find a connection between your symptoms and the consumption of dairy products. In the morning, eat a lactose-free breakfast (read the ingredients on the package if you are not sure) and evaluate how you feel. During the day, eat something with lactose, such as cheese, yogurt and/or milk. If you notice significant changes in how you feel, you may be lactose intolerant.
The life of some people is initially, from birth, complicated by genetic diseases associated with the inability to absorb certain nutrients.
Thus, lactose intolerance, the symptoms of which are similar to those of gastrointestinal diseases, is caused by a deficiency or complete absence of the lactase enzyme, which breaks down lactose into milk sugar components: galactose and glucose.
If unfermented, pure lactose enters the intestines, digestive problems arise due to fermentation of the products.
Dangerous indigestibility of the dairy ingredient is not only congenital and primary in children, but quite often lactose intolerance occurs in adults, the symptoms are combined with signs of diseases due to which the breakdown of complex sugar has developed: infections, allergies, giardiasis, pancreatitis, cirrhosis, etc. .
They need to be treated urgently, otherwise it can even lead to death. That's why it's important to get tested if you show signs of lactose intolerance.
At the same time, many people develop a lactose allergy, a completely different disease that occurs due to an immune response to foreign components. The symptoms of an allergy are very similar to the signs of lactose intolerance; in this case, the health of a person, especially a baby, is also at risk, therefore, when the first signs of intestinal “indigestion” appear, immediately consult a doctor.
Characteristic signs of adult diseases
Lactose intolerance, symptoms in adults are expressed by the following unpleasant phenomena:
- Flatulence, bloating.
- Colic and rumbling.
- sour-smelling, foaming stool.
- Pain in the navel area: spasms or aching pain.
- Nausea or vomiting.
- Irritability, fatigue, insomnia.
All this happens due to the fact that bacteria in the large intestine feed on undigested lactose and release hydrogen, methane, and other products that cause irritation and destruction of the mucous membrane.
Allergy to lactose, symptoms are as follows:
- Itchy rash.
- Runny nose.
- Swelling of the tissues of the mouth, larynx, lips.
- Sometimes the reaction is accompanied by redness of the eyes, tearfulness, vomiting, abdominal pain, and diarrhea.
A dairy allergy is an abnormal immune defense of the body.
Signs of illness in babies
Lactose intolerance symptoms in infants are expressed by the following manifestations:
- Frequent defecation with watery, sour-smelling stools, or constipation.
- Constant regurgitation with copious amounts of contents.
- Rumbling, bloating, excessive gas formation.
- Colic and pain.
- Restless state, the child sleeps little.
- Insufficient weight gain.
- Lactose intolerance in infants is sometimes caused by insufficient development of the gastrointestinal tract, and goes away on its own by the age of one year. In other cases, treatment is required, as well as the elimination of foods with milk sugar.
- Lactose allergy symptoms in infants are characterized as follows.
- Itchy skin rashes on the butt, neck, cheeks, tummy.
- Crusts on the scalp.
- Inflammation of the mucous membranes.
- Hives.
- Diathesis, dermatitis.
- Swelling of tissues.
- Sneezing, coughing.
- Tearfulness.
- The child constantly cries and worries from discomfort.
- Shortness of breath, frustrated wheezing.
The most dangerous manifestation is Quincke's edema. Therefore, if you have an allergy, immediately stop feeding your baby milk.
Allergy to lactose is not common, mainly an immune reaction occurs in response to an overdose of sugar, milk protein, and other foods with allergens that the mother ate, so her nutrition during breastfeeding should be chosen in the most critical way.
If your child shows signs of allergies, call a doctor immediately. The causes of allergies in a baby are varied: genetic, acquired due to difficult childbirth, stressful conditions of the mother during pregnancy, her toxicosis, or diseases.
The main treatment is the complete exclusion of foods that cause the reaction. Never treat a baby yourself, especially with herbs, this will lead to disaster.
How to eliminate lactose from your diet
What does lactose contain?
Of course, in all dairy products, fresh, dry, canned.
However, today it is added to almost all food industry products and some medicines. We list only a small part of the products:
- sausages and meat products,
- soup packets and instant porridges,
- dressing mixtures for side dishes and salads, mayonnaise,
- bakery goods, pastries, pies, pies,
- ice cream,
- sweet pastes,
- cookies, croquettes, gingerbreads,
- fast food: hamburgers,
- seasonings, sauces, mustard, spices,
- flavor enhancers and sweeteners,
- chocolate, toffee, lollipops, other sweets,
- instant coffee, cocoa with additives,
- packages with mashed potatoes, puddings, muffins powder.
- dietary supplements,
- Saccharin,
- Numerous tablets.
It is difficult to tell where else you can find lactose, so be sure to read the packaging and try to avoid cafes and canteens, as there products containing lactose are masked beyond recognition.
It is difficult to independently determine what interferes with proper digestion, so if symptoms of lactose intolerance or allergies appear, you need to establish an accurate diagnosis. Only a doctor should prescribe treatment, remember this. Otherwise, the discomfort of a less dangerous disease will be replaced by severe digestive dysfunction, diseases of the nervous and circulatory system.
Ecology of Health: Although lactose intolerance is not a serious condition, it can interfere with leading a normal life...
Although lactose intolerance is a relatively new condition, there are already quite a large number of people today who cannot tolerate milk and dairy products.
In this article we will tell you what signs you can use to understand that you suffer from lactose intolerance.
What is lactose intolerance
This is due to the absence in our body of the enzyme that is responsible for the breakdown of lactose.
When it is poorly digested, milk sugar enters the intestines, where it ferments and causes gas.
Consumption of milk, yogurt and ice cream by a person who suffers from lactose intolerance does not cause serious harm to the digestive tract, only causing unpleasant symptoms.
Many people believe that this problem is actually related to intestinal inflammation, celiac disease, or bacterial overgrowth in the body.
Genetic mutations in the human species have meant that we can now eat milk as adults.
However, some people still don't produce enough enzymes to absorb lactose and prevent symptoms.
Most patients suffer from an initial stage of lactose intolerance, where they can drink a cup of milk or eat a piece of cheese without suffering any unpleasant symptoms.
Choose foods low in lactose or take special lactase supplements.
Symptoms of lactose intolerance
Signs of intolerance may appear 30-120 minutes after we eat a product that contains lactose.
The intensity of symptoms depends on each person, the amount eaten and the degree of ineffectiveness of the lactase enzyme in the stomach.
Of course, it must be borne in mind that symptoms are not always associated with this particular disorder.
They may be caused by other pathologies or gastrointestinal diseases, especially acute gastroenteritis.
Try to use the “hint” - analyze the moment when these unpleasant symptoms appeared. If you've recently eaten milk, yogurt, cheese and ice cream, you may be lactose intolerant.
- Lactose fermentation is associated with the action of intestinal bacteria, which acidify stool, which causes irritation and burning during bowel movements.
- This process can also cause swelling, abdominal pain and severe gas, which do not go away a few hours after you have eaten something dairy.
- Gases and stool may have strong unpleasant odor.
Diarrhea or constipation may be associated with both lactose intolerance and intestinal imbalance in general.
Lactose intolerance is also very often accompanied by cramps or intestinal colic.
Children and teenagers with lactose intolerance often suffer from nausea and vomiting.
Chronic diseases (secondary lactase deficiency) may also be accompanied by:
- h significant weight loss,
- redness of the anus,
- abdominal cramps,
- involuntary defecation.
Patients may also suffer from skin diseases, severe fatigue and pain in the limbs.
How to cure lactose intolerance
If you think you are suffering from this problem, be sure to consult a specialist. The doctor will be able to conduct the necessary research and make the correct diagnosis.
The most commonly performed tests are:
1. Measuring the glycemic response
- A blood test is taken from the patient, which allows the initial glucose level to be calculated.
- After this, the patient is injected into the body with 50 g of lactose every 30 minutes for two hours (4 injections in total).
- The patient is given a repeat blood test to determine how glucose levels in the body have changed.
If these indicators are equal, this means that the lactase enzyme is not working.
However, this test is not very accurate because there are other pathologies that can change blood glucose levels, such as diabetes.
2. Hydrogen content in exhaled air
This is the most popular way to measure glucose intolerance. A person takes glucose and after 15 minutes exhales into a sealed bag.
If milk sugar is not digested and does not enter the intestines, bacteria use it as food and produce hydrogen.
If the concentration of hydrogen in your breath is too high, you may be suffering from a problem with digesting dairy products.
3. Small intestinal biopsy
Specimens for this study are obtained through endoscopy of the esophagus or gastrointestinal tract.
Fragments of intestinal tissue are then analyzed in the laboratory to determine the presence or absence of lactase in the mucous membrane.
4. Stool acidity
This test is most often done on young children because other procedures may be too difficult or dangerous for them.
5. Genetic test
This test should detect primary intolerance caused by the MSM6 gene.
A sample of a patient's blood or saliva allows analysis of two polymorphisms associated with this condition. published . If you have any questions about this topic, ask them to the experts and readers of our project .
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