Lactose intolerance: symptoms, causes and treatment

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Definition of lactose intolerance

What is lactose intolerance?

Lactose intolerance is a digestive disorder that occurs when the intestines are unable to digest lactose. Lactose is a type of sugar that is found in animal milk and its processed products, such as cheese, ice cream, yogurt, and butter (butter).

Normally, the small intestine needs an enzyme called lactase to break down lactose into sugar in its simpler form, namely glucose and galactose. The body then absorbs these simple sugars into the bloodstream for energy.

When it can't be digested and absorbed by the body, lactose eventually turns into gas which causes various symptoms of digestive problems.

According to the Cleveland Clinic, an estimated 68% of the world's population has lactose intolerance. Most people with this digestive system disorder are of ethnic and racial origin, such as Latin American, African-American, Asian, and Eastern European.

One condition similar to lactose intolerance (lactose intolerance) is a milk allergy (cow milk allergy). Milk allergy is a condition related to the immune system. A person can experience an allergic reaction if their immune system is sensitive to milk protein.

Signs & symptoms of lactose intolerance

What are the signs and symptoms of lactose intolerance?

Symptoms of lactose intolerance can usually start to appear within 30 minutes to 2 hours of eating a dairy dish. There are some people who are so sensitive to lactose that symptoms can appear quickly and are severe.

However, there are also some people who can still consume small amounts of lactose. Symptoms that appear may also be mild or subtle.

Symptoms of lactose intolerance that generally appear are as follows.

1. Stomach pain, bloating, and / or cramps

Lactose that enters the body will be digested and undergo a fermentation process. During this fermentation process, lactose will release fatty acids and a collection of gases in the form of hydrogen, methane and carbon dioxide.

Excess acid and gas can cause flatulence, pain, and even cramps.

2. Diarrhea

People who cannot digest lactose are prone to experiencing diarrhea symptoms. Diarrhea occurs as the body's reaction when the volume of water in the large intestine increases. The more fluid that is drained into the intestine, the more water is carried along with the feces.

3. Other symptoms

Apart from the three symptoms above, there are some other symptoms that are less common, such as:

• headache,
• fatigue,
• lose concentration, and
• there was a roar from the stomach.

However, these symptoms have not been established as true symptoms and may have other causes.

Meanwhile, the symptoms of lactose intolerance in children may be slightly different, namely:

• frothy diarrhea,
• slowed growth and development, and
• sometimes vomiting.

There may be signs and symptoms not listed above. If you have concerns about certain symptoms, consult your doctor.

When should I see a doctor?

If you experience the above symptoms after consuming foods containing lactose, consult your doctor immediately. Likewise, if you experience symptoms that are not mentioned, considering that each person can have a different reaction.

Causes of lactose intolerance

What causes lactose intolerance?

The cause of lactose intolerance is the body does not have enough of the enzyme lactase to digest the sugar in milk. However, this condition can also be caused by the following factors.

1. Primary lactose intolerance

This type of intolerance is generally shared by people who have previously consumed dairy products without any problem.

Almost every body of a person born into the world will produce enough lactase to digest the lactose in breast milk and infant formula. However, for some people, this condition can develop with age.

Generally, after a long period of stopping milk consumption, the intestines will produce less of the enzyme lactase. These changes make them more susceptible to intolerance over time.

2. Secondary lactose intolerance

This type of intolerance occurs temporarily due to the influence of disease on the digestive system, side effects of surgery, or while taking certain drugs.

One disease that often causes people to become intolerant of milk is acute gastroenteritis. The infection causes temporary damage to the lining of the intestine while it hurts.

People with vomiting tend to experience nausea, vomiting, and diarrhea when eating foods containing lactose. However, once healed, his body was able to digest lactose again as usual.

3. Congenital lactose intolerance

This condition is caused because a person does not produce the lactase enzyme from birth due to an inherited genetic disorder. Both parents must have the mutated gene in order to pass this condition on to the baby.

Lactose intolerance risk factors

What increases my risk for lactose intolerance?

Here are various factors that increase your risk of developing lactose intolerance.

• Age. Lactose intolerance can be experienced by anyone, but the symptoms tend to become more pronounced as you age.
• Born prematurely. Babies born prematurely can experience lactase deficiency because their small intestine is not fully formed. The baby's gut does not form lactase-producing cells until the end of the third trimester.
• Certain diseases. Diseases affecting the small intestine such as Celiac or Crohn's disease can interfere with the amount of intestinal enzymes, including lactase.
• Treatment. People who undergo cancer treatments such as radiation therapy or chemotherapy that focus on the stomach are at a higher risk.

Lactose intolerance complications

What are the complications that can occur due to lactose intolerance?

Lactose basically functions to help the absorption of other nutrients in food. Meanwhile, all dairy dishes generally contain magnesium, calcium, zinc, protein, as well as vitamin A, vitamin B12, and vitamin D.

All these minerals and vitamins are important for maintaining a healthy body. Calcium, magnesium and zinc, for example, are essential for the development of strong and healthy bones.

If your body is unable to absorb lactose, you will be at higher risk for health problems due to deficiencies in certain nutrients. For example, you may be at increased risk of developing osteopenia (low bone density) or osteoporosis.

If you are lactose intolerant and are concerned about the complications it may cause, consult a dietitian. A nutritionist can adjust your diet or suggest taking supplements to meet your nutritional needs.

Diagnosis of lactose intolerance

How do doctors diagnose this condition?

There are three tests most commonly used to diagnose lactose intolerance, namely the lactose tolerance test, the hydrogen breath test and the stool acidity test.

1. Lactose intolerance test

This test can be used for both children and adults. You will usually be asked to fast from eating and drinking anything else for a few hours before the test begins. Then, your blood will be checked what is the current blood glucose level.

Next, you will be asked to drink a liquid containing 50 grams of lactose. A second blood sample will be taken to see if there is any change in the blood glucose level.

If the body is able to digest lactose, blood glucose levels will rise. However, if the glucose level does not rise, this indicates that the lactose is not being broken down because you have a lactose intolerance.

2. Hydrogen breath test

This test procedure is very similar to the lactose intolerance test. After fasting for a few hours, you will be asked to exhale into a funnel that is connected to a foil pouch like a balloon.

Next, you will drink fluids that contain up to 50 grams of lactose. This process is likely to be repeated a number of times over a period of 6 hours.

Normally, breath doesn't contain hydrogen. If you find that your breath contains hydrogen, it is likely lactose intolerance. Hydrogen is present in the breath when the intestines cannot process lactose into energy.

3. Stool acidity test

This test is usually done on babies and young children. Stool samples will be collected and tested with lactic acid, glucose, and other short chain fatty acids. If there is undigested lactose, the cause is likely intolerance.

This examination is quite safe without causing problems such as dehydration due to diarrhea. Diarrhea is a common side effect of other tests. This condition is usually caused because the patient needs to ingest large amounts of lactose.

Drugs & treatment of lactose intolerance

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the treatment options available?

Lactose intolerance cannot be cured. This condition can only be controlled by symptoms and trigger factors. Most people can relieve symptoms by changing their diet and limiting the amount of lactose they consume.

Some people prevent it even better by reducing their intake of lactose from their diet altogether. Here are some steps you can take.

1. Eat a nutritionally balanced diet

By limiting the consumption of products made from milk, it does not mean that you are definitely deficient in calcium intake. There are a variety of lactose-free foods that contain calcium, such as:

• broccoli,
• calcium-fortified products such as bread and juices,
• salmon,
• other milk alternatives such as soy milk and rice milk,
• oranges, as well
• spinach.

Also make sure you are getting enough vitamin D, which is usually found in milk. You can eat, eggs, liver, and yogurt that contain vitamin D. The body can also naturally produce vitamin D when you are exposed to sunlight.

Apart from food, you can also consult a doctor regarding the consumption of calcium or vitamin D supplements. Supplements can help meet the nutritional needs that you do not get from food.

2. Limit dairy products

Preventing the appearance of symptoms as well as the severity of lactose intolerance requires that you limit your consumption of dairy products such as the following.

• Milk, milkshake , and smoothies those made with milk or yogurt, or other animal-based drinks.
• Whipped cream (whipped cream) and creamer dairy .
• Ice cream, ice milk, gelato, yogurt, milk pudding, or any cold snack that contains milk.
• Cheese or butter.
• Creamy soups or sauces and creams from milk (eg, pasta sauce carbonara).
• Other foods made with milk.

Other non-dairy foods that may contain small amounts of lactose include:

• bread and pastries,
• chocolate candy,
• salad dressing and sauce,
• cereals and products of their creations,
• meat,
• candy and snacks,
• pancake and biscuit dough,
• margarine,
• offal (like heart),
• sugar beet,
• peas, and
• lima beans.

You can limit your consumption of excess dairy products when you are lactose intolerant with the following steps:

• Limit drinking milk, a maximum of 118 ml or the equivalent of one small cup. The less milk you eat, the less risk of developing symptoms.
• Try drinking milk with other foods. This can slow down the digestive process and reduce symptoms of lactose intolerance
• Choose lactose-free or low-lactose dairy products, such as cheese cheddar and yogurt.
• Buy a product or food that is lactose low or even lactose free.
• Taking tablets containing the enzyme lactase to aid in the digestion of milk. However, make sure you have consulted your doctor first.

3. Consuming probiotics

Probiotics are good bacteria that help maintain a healthy digestive system. Probiotics can increase the number of good bacteria in your gut to help relieve symptoms of intolerance.

Probiotics are usually synonymous with yogurt. However, people with lactose intolerance can also take safer versions of tempeh or probiotic supplements.

Home treatment of lactose intolerance

What are some lifestyle changes or home remedies that can be done to treat this condition?

Here are lifestyle and home remedies that can help you treat and prevent the disease from getting worse.

• Get enough calcium and vitamin D from food or supplements.
• Tell your doctor about all medicines you take.
• Consider again if you want to breastfeed your baby with formula milk, especially if you have a family history of lactose intolerance.
• Consume soy-based or lactose-free milk formulas.
• Call your doctor if a dairy-free diet doesn't help relieve symptoms.
• Call the doctor if your child is not gaining weight or if your child refuses food or formula milk.

Lactose intolerance is a condition that makes you unable to digest the sugar in milk properly. This condition can be overcome by adjusting the diet. If you have any questions, consult your doctor for the best solution to your problem.