basic info about lactose intolerance

1. LACTOSE INTOLERANCE

2. Lactose
Lactose is a disaccharide of β-Dgalactose and β-D-glucose in β(1,4)
linkage.
 Human milk contains 200mmol/lit of
lactose.
 It is digested by enzyme lactase to
form glucose and galactose in the
brush border of the intestine.


3. Lactose containing food stuffs
Fresh, skimmed , non fat and
condensed milk.
 Cream
 Yoghurt
 Cheese
 Processed foods
 Stuffings
 Salad dressings etc.


4. Lactose intolerance
Lactose intolerance, also called
lactase deficiency or hypolactasia,
is the inability to digest and metabolize
lactose, a sugar found in milk.
 Lactose intolerance is not an allergy
because it is not an immune response
but caused by lactase deficiency.


5. Lactose intolerance
Lactose intolerance can occur in any
age group or population.
 However, people of
African, Jewish, Hispanic, Asian, Middl
e Eastern and Native American
descent, Caucasians are at risk for
developing lactose intolerance.


6. Symptoms
Abdominal bloating and cramps
 Flatulence
 Diarrhoea
 Nausea
 Borborygmi (rumbling stomach)
 Vomiting (particularly in adolescents).


7. Types of lactase deficiency
Primary lactase deficiency is a
genetically determined absence or
decrease in the enzyme is noted.
 Jejunal morphology is normal.
 In non caucasian groups, primary
lactase deficiency is abnormal in
adulthood.


8. Secondary lactase deficiency
Secondary, acquired, or transient
lactase deficiency is due to the small
intestinal mucosal
disease, abnormalities of brush border
cells and transport processes.
 It is often associated with celiac sprue.


9. Congenital lactase deficiency
Congenital lactase deficiency is a
very rare, autosomal recessive genetic
disorder that prevents lactase
expression from the first feed.
 Congenital lactose intolerance is
serioue disorder in which the infants
may fail to thrive unless given lactose
free formula feed.


10. Diagnosis
Dietary history of the patient who are
complaining flatulance , abdominal
pain , diarrhoea.
 Familial history of the patient.
 Check whether the patient has
underwent partial gastrectomy and
other related procedures.
 Tests – stool acidity test, hydrogen
breath tests.


11. Misdiagnosis
Irritable bowel syndrome
 Crohn's disease
 Food poisoning
 Gastroenteritis.
 Celiac disease.


12. Management
Avoiding lactose-containing products
 Alternative products such as Plantbased milks and derivatives are
inherently lactose free: soy milk, rice
milk, almond milk, hazelnut milk, oat
milk, hemp milk, peanut
milk, horchata.
