Lactose intolerance / Lactase deficiency

Lactose, the milk sugar is a molecule with glucose and galactose. This must be split into glucose and galactose, otherwise the absorption of lactose is not possible in the small intestine.

Lactase, the enzyme in charge to do this is present in the lining of the small intestine. If lactase is present in small amount or it is absent the splitting of lactose is prevented partially or completely.

Lactose intolerance is therefore an inability to digest and absorb lactose, the milk sugar by people who have no lactase. If milk or milk products are consumed gastrointestinal symptoms is the result.

The unabsorbed lactose passes through the small intestine into the colon. The bacteria present there split the lactose into glucose and galactose. In this process of utilization of glucose and lactose by the bacteria hydrogen and methane gas. A part is absorbed into the body and the rest is expelled from the body. There is still no 100% splitting and the rest could absorb water from the body which could cause diarrhea.

The symptoms of lactose intolerance include:

• Abdominal pain
• Abdominal bloating
• Abdominal swelling
• Diarrhea
• Flatulence
• Nausea

These symptoms are also common in other gastrointestinal diseases and so even most of the doctors miss this. I have helped several patients. If the intake of milk and milk products are stopped this problem vanishes immediately.
Not in all patients the lactase is 100% absent. It is individual and many can have it in different amounts. You have to test how much milk you could drink or milk products you could eat.
The best thing to master this problem is not only avoiding milk and milk products but also avoiding all the processed food where milk powder or condensed milk is present. The food which may contain hidden lactose include:

• Bread, cakes and other baked foods
• Processed breakfast cereals
• Breakfast drinks
• Ready made soups
• Margarine
• Salad dressings
• Chocolates, cabndies and other sweet snacks
• Icecreams
• Mixes for pancakes, biscuits and cookies

There are many other food where it is declared as whey, curds, milk bye-products, dry milk solids, nonfat dry milk powder etc. mean that lactose is present in these foods.
Powdered coffee creamer and whipped toppings may also contain ingredients from milk and can contain lactose. Be careful, these are normally declared as nondiary on their labels.
The long-term health consequence of lactose intolerance may be calcium deficiency which leads to osteoporosis. But without milk and milk products it is possible to manage the calcium intake if you eat the right food. Here your doctor or dietician could help you. Otherwise, it is better to take calcium supplements and these must be taken between two meals so that it will not disturb iron absorption. Before taking the supplement always consult with your doctor.

What is the difference from food allergy and food intolerance?

Food allergy is an immune reaction, but food intolerance has no connection with the immune system.

Lactose intolerance is food intolerance where the enzyme lactase needed to digest milk sugar in milk and dairy products is absent in our body. This can cause diarrhoea, gas, abdominal pain and bloating.

A protein is responsible for milk allergy.

In food allergy, your immune system wrongly identifies a particular food or a component of the food as a harmful substance and attacks it. The symptoms can be tingling in the mouth, swelling of the lips, face, tongue and throat, hives, wheezing, breathing difficulties, dizziness and fainting.

In food intolerance you can eat small amount without a reaction and this should be found individually, but in food allergy, the smallest amount is enough to start the allergic reactions.