People with lactose intolerance are unable to fully digest the sugar (lactose) in milk. As a result, they have diarrhea, gas and bloating after eating or drinking dairy products. The condition, which is also called lactose malabsorption, is usually harmless, but its symptoms can be uncomfortable. This disorder hinders the ability to properly metabolize this sugar, which can adversely affect health & wellness. Crohn’s disease and lactose intolerance share many of the same symptoms and confuses the person to believe to be suffering one condition when it is, in fact, the other.
A deficiency of lactase — an enzyme produced in your small intestine — is usually responsible for lactose intolerance. Many people have low levels of lactase but are able to digest milk products without problems. If you’re actually lactose intolerant, though, your lactase deficiency leads to symptoms after you eat dairy foods.
Most people with lactose intolerance can manage the condition without having to give up all dairy foods.
Your body needs the enzyme lactase to break down lactose in your small intestine. Without sufficient lactase, lactose passes through your colon intact, where bacteria metabolize it instead. Bacterial breakdown of lactose results in abdominal bloating and cramps, diarrhea, gas and nausea.
The signs and symptoms of lactose intolerance usually begin 30 minutes to two hours after eating or drinking foods that contain lactose. Common signs and symptoms include:
• Nausea, and sometimes, vomiting
• Abdominal cramps
Lactose intolerance occurs when your small intestine doesn’t produce enough of an enzyme (lactase) to digest milk sugar (lactose).
Normally, lactase turns milk sugar into two simple sugars — glucose and galactose — which are absorbed into the bloodstream through the intestinal lining.
If you’re lactase deficient, lactose in your food moves into the colon instead of being processed and absorbed. In the colon, normal bacteria interact with undigested lactose, causing the signs and symptoms of lactose intolerance.
There are three types of lactose intolerance. Different factors cause the lactase deficiency underlying each type.
* Primary lactose intolerance
This is the most common type of lactose intolerance. People who develop primary lactose intolerance start life producing plenty of lactase — a necessity for infants, who get all their nutrition from milk.
In primary lactose intolerance, lactase production falls off sharply, making milk products difficult to digest by adulthood. Primary lactose intolerance is genetically determined, occurring in a large proportion of people with African, Asian or Hispanic ancestry. The condition is also common among those of Mediterranean or Southern European descent.
* Secondary lactose intolerance
This form of lactose intolerance occurs when your small intestine decreases lactase production after an illness, injury or surgery involving your small intestine. Among the diseases associated with secondary lactose intolerance are celiac disease, bacterial overgrowth and Crohn’s disease. Treating this disorder may restore lactase levels and improve signs and symptoms, but it can take some time.
* Congenital intolerance
In rare cases, babies can be born with lactose intolerance caused by a complete absence of lactase activity. This disorder is passed from generation to generation. Both the mother and the father must pass on the same gene variant for a child to be affected. Premature infants may also have lactose intolerance because of an insufficient lactase level.
Risk Factors –
Factors that can make you prone to lactose intolerance may include:
• Increasing age. Lactose intolerance usually appears in adulthood.
• Premature birth. Infants born prematurely may have reduced levels of lactase because the small intestine doesn’t develop lactase-producing cells until late in the third trimester.
• Diseases affecting the small intestine. Small intestine problems that can cause lactose intolerance include bacterial overgrowth, celiac disease and Crohn’s disease.
• Certain cancer treatments. If you have received radiation therapy for cancer in your abdomen or have intestinal complications from chemotherapy, you have an increased risk of lactose intolerance.
Treatment and Lifestyle Modifications –
There are no permanent treatments for lactose intolerance. Most people with lactose intolerance do not have to completely avoid dairy products. Your physician may suggest reduced servings of dairy products, lactose-free dairy or lactase enzyme supplement pills.
You can usually avoid the discomfort of lactose intolerance by:
• Avoiding large servings of milk and other dairy products
• Including small servings of dairy products in your regular meals
• Eating and drinking lactose-reduced ice cream and milk
• Drinking regular milk after you add a liquid or powder to it to break down the lactose
You may be able to predict your body’s response to different foods containing lactose and figure out how much you can eat or drink without discomfort.
Good Nutrition –
Reducing the dairy products doesn’t mean you can’t get enough calcium. Calcium is found in many other foods, such as:
• Calcium-fortified products, such as breads and juices
• Canned salmon
• Milk substitutes, such as soy milk and rice milk
• Pinto beans
You also need to get enough vitamin D, which is typically supplied in fortified milk. Eggs, liver and yogurt also contain vitamin D, and your body makes vitamin D when you spend time in the sun.
Most people with lactose intolerance can enjoy some milk products without symptoms. You may be able to tolerate low-fat milk products, such as skim milk, better than whole-milk products. It also may be possible to increase your tolerance to dairy products by gradually introducing them into your diet.
Here are a few tips that can help you change your diet to minimize symptoms of lactose intolerance include:
• Choose smaller servings of dairy. The smaller the serving, the less likely it is to cause gastrointestinal problems.
• Save milk for mealtimes. Drink milk with other foods. This slows the digestive process and may lessen symptoms of lactose intolerance.
• Experiment with an assortment of dairy products. Not all dairy products have the same amount of lactose. For example, hard cheeses, such as Swiss or cheddar, have small amounts of lactose and generally cause no symptoms. You may be able to tolerate cultured milk products, such as yogurt, because the bacteria used in the culturing process naturally produce the enzyme that breaks down lactose.
• Buy lactose-reduced or lactose-free products. You can find these products at most supermarkets in the refrigerated dairy section.
• Use lactase enzyme tablets or drops. Over-the-counter tablets or drops containing the lactase enzyme (Dairy Ease, Lactaid, others) may help you digest dairy products. You can take tablets just before a meal or snack. Or the drops can be added to a carton of milk. Not everyone with lactose intolerance is helped by these products.
• Use probiotics . Probiotics are living organisms present in your intestines that help maintain a healthy digestive system. Probiotics are also available as active or “live” cultures in some yogurts and as supplements in capsule form. They are sometimes used for gastrointestinal conditions, such as diarrhea and irritable bowel syndrome. They may also help your body digest lactose. Probiotics are generally considered safe and may be worth a try if other methods don’t help.
Crohn’s disease and lactose intolerance share many of the same symptoms and this causes a person to believe he/she is suffering from one condition when it is, in fact, the other.
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