Updates from Sierra Nevada Memorial Hospital and Hospital Foundation
We often hear people refer to being lactose intolerant, but what does that mean? Lactose intolerance is a digestive disorder caused by the inability to digest the main carbohydrate in dairy products, lactose. An enzyme called lactase is produced by the cells in the lining of the small intestine. Lactose is normally broken down by lactase.
Statistics vary, but most cite 65 to 75% of the worldwide population has a reduced ability to digest lactose. The most significant number of cases are found in people of East Asian descent followed by people of West African, Jewish, Arab, Greek and Italian heritage.
What many people don’t realize is there are different types of lactose intolerance. In infants, it is called congenital lactase deficiency or congenital alactasia. It is caused by mutations of the LCT gene which provides instruction for making the lactase enzyme resulting in an infant’s inability to break down lactase in breast milk or formula.
The most common type is primary lactose intolerance. People who develop this start life producing enough lactase, but production falls off sharply by adulthood making it difficult to digest milk products.
Secondary lactose intolerance occurs after an illness, injury or surgery involving the small intestine. Intestinal infection, celiac disease, Crohn’s disease and a bacterial overgrowth are associated with secondary lactose intolerance.
Risk factors are age and ethnicity, followed by premature birth, diseases of the small intestine and certain cancer treatments of the intestine. Symptoms vary, but are related to digestive problems. If you have serious bloating, abdominal cramps, gas and diarrhea, you can start by removing dairy products from your diet.
While most of us recognize the dairy foods that contain lactose such as cow’s milk, cheese, ice cream, yogurt and butter, people often overlook foods that sometimes contain lactose. These include biscuits, cookies, cakes, breakfast cereals, instant soups, sauces, potato chips, flavored tortillas and ready-made meals. It is important to check ingredients for well-known dairy products, but also for whey, curds, sour cream and more.
And while all dairy products include lactose, it doesn’t necessarily mean it is totally off limits. Most people are able to tolerate small amounts of lactose. For example, some may be able to manage the amount of milk in a cookie, but not the amount in a bowl of cereal.
For those who don’t want to give up dairy, talk to your doctor. There are enzyme supplements that help to digest lactose although the effectiveness varies person to person. Probiotics (microorganisms that provide health benefits when consumed) and Prebiotics (a type of fiber that function as food for these bacteria), have been shown to reduce symptoms although studies still are not fully conclusive.
Bottom line, if you are feeling ill and suspect lactose intolerance but are not sure, it is a good idea to see your physician and take a food diary of what you ate that includes the dates you felt ill.
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