Lactose intolerance is a condition in which consumption of lactose, which occurs naturally in unfermented or relatively fermented milk and dairy products, causes a non-allergic adverse reaction.
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What is lactose intolerance?
Lactose intolerance is characterized by an inability to efficiently digest the sugar found in milk and its derivatives. It occurs when the enzyme lactase, which is responsible for breaking down this sugar, is lacking in the intestines.
Lactose, the sugar found in milk, requires the presence of lactase to be properly digested. In its absence, lactose ferments in the colon, causing digestive problems such as abdominal pain, diarrhea, and bloating.
It's important to note that infants cannot be lactose intolerant because they naturally produce large amounts of lactase. However, this ability often declines after we stop breastfeeding, although this varies from person to person. Some people maintain high levels of lactase activity into adulthood, while others experience a gradual decline.
Types of lactose intolerance
Lactose intolerance can be divided into two types:
- Primary lactose intolerance: In this case, the body does not produce lactase due to a genetic defect. Symptoms of intolerance are therefore visible from early childhood.
- Secondary lactose intolerance: This type of intolerance occurs when enzyme production is temporarily reduced, even though the lactase deficiency is not permanent. In this case, the phenomenon is transient. Lactase synthesis occurs in response to dietary stimulation, i.e., when milk and dairy products are included in the diet. If the dietary intake of lactose is insufficient, a temporary loss of the enzyme may occur.
What are the main symptoms?
Symptoms of lactose intolerance generally appear half an hour to two hours after a meal containing lactose (milk sugar).
The main symptoms of lactose intolerance include:
- A feeling of bloating in the abdomen.
- Diarrhea.
- An excess of gas.
- Headache.
- Feeling very tired.
- Joint and muscle pain.
- Stomach cramps.
The severity of symptoms depends on the dose of lactose consumed. Most people with lactose intolerance can tolerate a certain amount of lactose without adverse effects. The amount that can be tolerated may increase if lactose is consumed during a meal or throughout the day.
What causes lactose intolerance?
There are many possible reasons for developing lactose intolerance. These may include
- Primary lactose, which is caused by a genetic mutation.
- Certain diseases of the digestive system, such as celiac disease, Crohn's disease, or ulcerative colitis, can damage the intestinal lining and reduce lactase production.
- Certain cancers of the digestive system (small bowel or colon cancer) can lead to an inability to produce lactase.
On the other hand, in about 58% of adults, lactose intolerance is the result of a natural physiological process. With age, lactase activity gradually declines, making it more difficult to digest lactose.
How is the diagnosis made?
It is important to consult one of the best gastroenterologists to look for any other disease such as benign liver tumors, hepatic cysts, or irritable bowel syndrome. A biological test that detects the concentration of hydrogen in the air after consuming a liquid containing 30 grams of lactose is extremely important.
If there is a high concentration of hydrogen after 4 hours of testing, it indicates that the body is not absorbing the lactose.
Treatment of the disease in Turkey
It should be noted that there are no surgeries or medications that can permanently eliminate lactose intolerance. However, the main goal of treatment is to reduce the side effects of this condition.
In the case of secondary lactose intolerance, it is advisable to reduce the consumption of milk and its derivatives containing the disaccharide (especially unfermented). These should then be gradually increased to stimulate lactase production.
There are also several lactose-free products on the market. In this regard, you can make do with vegetable milk, including soy, rice, oat, etc.
You should also maintain a diet rich in calcium to provide the body with the nutrients it needs.
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