In this post, we will focus on an example of food intolerance which is quite common among the majority of the population namely lactose intolerance. You will get to understand what lactose intolerance is, the different types of lactase deficiency, how it is diagnosed and how it is managed.
What Is Lactose Intolerance?
Lactose intolerance is resultant from the deficiency of enzyme lactase (digests lactose).Persons with lactose intolerance cannot tolerate ingested lactose. When such persons take lactose-containing foods, they experience certain gastrointestinal symptoms including bloating, flatulence, abdominal discomfort and diarrhoea, after about half an hour from ingestion of those foods.
Types Of Lactase Deficiency
Lactose intolerance is not considered a condition but is rather perceived as a physiological process. Lactase deficiency can either be primary or secondary with primary lactase deficiency being the most common type. Primary deficiency results from the normal physiological function whereby lactase production is limited; whereas, secondary lactase deficiency is usually observed among persons with particular conditions such as iron deficiency, protein-energy malnutrition celiac sprue, Chrons disease and AIDS. Individuals who have undergone extensive use of parenteral nutrition or surgical procedures of the gastrointestinal tract may also encounter this deficiency; though, in such cases it usually subsides over time.
There is the rarer type of lactose intolerance known as Congenital lactose intolerance which is frequently identified among new-born babies. Congenital lactose intolerance presents with dehydration and diarrhoea that can be severe. This form of lactose intolerance is normally detected by performing a biopsy and enzyme analysis, and managed by immediately introducing lactose-free formulas.
The Diagnosis Of Lactose Intolerance
To diagnose the condition, the following procedures are undertaken:
- A diet history -If patient reports that they experience relief after lowering the amount of lactose intake, then this could signify the presence of lactose intolerance.
- A biopsy of the intestinal mucosa- To establish lactase deficiency.
- A lactose tolerance test-A lactose dosage is provided orally, and in the incidence of lactose intolerance, the blood glucose levels will increase but will not exceed 25mg/dl.
- A breath hydrogen analysis test-Elevated levels of hydrogen concentration to approximately 10-20 ppm are indicative of reduced lactase activity.
The Management Of Lactose Intolerance
The management of lactose intolerance requires that the patient consume lactose-containing foods they can tolerate rather than completely restricting lactose foods. Milk and other dairy products contain significant amounts of calcium, Vitamin B2, Vitamin D and protein; and since the management of lactose intolerance requires a lactose-restricted diet, it is imperative that the mentioned nutrients contained in lactose-containing foods be monitored intricately. A dietitian may prescribe supplements of any of these nutrients if they lack or are limited in your diet.
Specific foods that may cause distress after lactose intake include:
- Milk and dairy products- except yoghurt
- Vegetables prepared with cheese, ghee or milk
- Desserts such as ice cream, custard
- Soups and sauces -cream soups and sauces, chowder
- Candy containing milk, caramels, butterscotch
- Fats e.g. whipped cream
Most individuals with lactase deficiency can tolerate a cup of milk (contains 12 g of lactose) in a day and others even up to 2 cups of milk in a day. Better yet, most of lactose intolerant persons can consume fermented dairy products especially yoghurt without experiencing any distress. All in all, the tolerance levels of lactose among persons who cannot digest lactose varies on an individual basis -while one may tolerate more of the lactose another may not. Thus, it is proper to seek guidance from a qualified dietitian.