Lactose intolerance is the inability to digest this substance, which is the main sugar found in milk and derivatives. It is caused by a total or partial lack of lactase, the enzyme needed to digest lactose in the small intestine. It is not considered a dangerous condition, but it can cause annoying stomach or intestinal disorders (bloating, abdominal pain, flatulence) and lead to restrictive food choices. Many adults are lactose intolerant with no other ailments. However, remember that many other diseases and pathological situations also cause gastrointestinal problems, so knowing exactly how to recognize the symptoms associated with intolerance is important.
Steps
Part 1 of 2: Recognizing the Symptoms
Step 1. Watch out for gastrointestinal symptoms
As with many conditions, it's hard to tell if your symptoms are unusual. For example, if a person regularly suffers from gastrointestinal problems after meals, they probably consider it "normal" and think that others feel the same way. However, having bloating, flatulence (gas production), cramps, nausea, and watery stools (diarrhea) after meals are not normal at all and are always symptomatic of digestive problems. Several diseases and disorders cause similar gastrointestinal symptoms, so diagnosis can be difficult. The first step is to understand that having problems of this type is not normal and should not be considered inevitable.
- Lactase splits lactose into its simple components, glucose and galactose, which are absorbed by the small intestine and transformed into energy by the body.
- Not all people with lactase deficiency suffer from digestive or gastrointestinal problems: while producing low amounts of this enzyme, they are still able to digest lactose.
Step 2. Find out if these symptoms are associated with the consumption of milk and dairy products
The classic signs of lactose intolerance (bloating, abdominal pain, flatulence and diarrhea) often occur between 30 minutes and two hours after consuming foods or drinks containing this complex sugar. Consequently, try to understand if there is a correlation between these gastrointestinal disorders and the consumption of dairy products. In the morning, eat breakfast avoiding lactose-containing products (read labels if in doubt) and see how you feel. For lunch, try eating cheese or yogurt, or drinking a glass of milk instead. If the gastrointestinal system reacts substantially differently, then it is very likely that it is lactose intolerance.
- If after both meals you notice bloating and flatulence, then it may be that you have a stomach or intestinal problem, such as inflammatory bowel disease (for example Crohn's).
- If you feel pretty good after both meals, then it is possible that you are allergic to other substances you take.
- This approach is usually referred to as an "elimination diet". In this case, it is necessary to avoid milk and derivatives in order to understand by exclusion the causes of one's gastrointestinal problems.
Step 3. Distinguish between lactose intolerance and milk allergy
The intolerance is essentially due to the lack of an enzyme, so the undigested lactose ends up in the large intestine (the last part of the digestive system). At that point, the intestinal bacteria consume the sugar and produce hydrogen (and methane) gas as a side effect. This explains the bloating and flatulence typical of lactose intolerance. Instead, milk allergy is an abnormal response of the immune system to dairy products. It often occurs within minutes of exposure to the responsible protein (casein or whey protein). Symptoms may include wheezing-wheezing, hives, swelling in the lip / mouth / throat area, runny nose, watery eyes, vomiting and digestive problems.
- Cow's milk allergy is one of the most common among children.
- Cow's milk usually causes an allergic reaction, but sheep, goat, and other mammalian milk can also trigger it.
- Adults with hay fever or other food allergies are more likely to have a negative reaction to dairy products.
Step 4. Remember that lactose intolerance is often associated with ethnic factors
It is true that the amount of lactase produced in the small intestine decreases over the years, but this mechanism is also linked to genetics. In fact, among certain ethnic groups the incidence of lactase deficiency is quite high. For example, about 90% of Asians, 80% of African Americans and 80% of Native Americans are lactose intolerant. The disorder is less common among populations native to Northern Europe. Consequently, if you are of Asian or African American descent and often experience gastrointestinal discomfort after meals, it is quite likely that they are caused by lactose intolerance.
- Lactose intolerance is unusual among infants and children, regardless of ethnicity. It is a disorder that generally appears in adulthood.
- However, premature babies may have a limited ability to produce lactase because they do not have a fully developed intestine.
Part 2 of 2: Confirm Lactose Intolerance
Step 1. Undergo the hydrogen breath test
It is the most common test for diagnosing lactase deficiency. It is done in a specialist's office or hospital, usually after trying the elimination diet. To do the test, you need to drink a sweet liquid containing a lot of lactose (25 grams). The doctor therefore measures the amount of hydrogen gas in the breath at regular intervals (every 30 minutes). If the patient can digest lactose, little hydrogen will be detected, even no trace at all. For those who are lactose intolerant, the detection gives rise to much higher values: the sugar ferments in the colon due to the bacterial flora and gas is produced.
- The hydrogen breath test is effective in confirming lactose intolerance because it is quite reliable and very affordable.
- To get tested, you usually have to fast the night before and avoid smoking.
- Using too much lactose causes false positives for some patients, and the same goes for bacterial overgrowth in the colon.
Step 2. Learn about your blood glucose or lactose tolerance test
It is a blood test used to assess the body's reaction to the consumption of high levels of lactose (usually 50 grams). Your doctor measures your fasting blood sugar, which will be your reference value. Next, a lactose-based drink must be consumed. The measurement carried out on an empty stomach and the readings taken one to two hours after the consumption of this sugar are therefore compared. If, in the time interval analyzed, blood sugar does not exceed the reference value by 20 g / dl, the body does not digest and / or absorb lactose correctly.
- The blood glucose or lactose tolerance test is an older method of diagnosing the disorder and is not performed as often as the hydrogen breath test. In any case it can be useful.
- The blood glucose or lactose tolerance test has a sensitivity of 75% and a specificity of 96%.
- False negatives occur among diabetic subjects and in the case of bacterial proliferation in the intestine.
Step 3. Learn about the stool acidity test
Undigested lactose produces lactic acid and other fatty acids in the colon, which end up in the excrement. This test is usually given to infants and younger children. It can detect the presence of these acids through a stool sample. The patient is given a small amount of lactose, then several consecutive stool samples are taken and tested to see if the acidity levels are higher than normal. A baby may also have glucose in the stool due to undigested lactose.
- For children who cannot have other tests to confirm lactose intolerance, this test is a good alternative.
- While this test is effective, the hydrogen breath test is usually preferred due to its convenience and convenience.
Advice
- If you can't give up milk for cereal or coffee, buy products that are low in lactose or free. Alternatively, try soy or almond milk.
- Maybe you can tolerate skim milk products better than those containing whole milk.
- Some dairy products, such as hard cheeses (gruyere and cheddar), contain small amounts of lactose and often do not cause gastrointestinal problems.
- To aid in the digestion of lactose, you can also take lactase supplements in tablets or drops just before a meal or snack.
- People with other gastrointestinal conditions, such as traveler's diarrhea, may become temporarily intolerant to lactose.
- Here are some foods rich in lactose: cow's milk, smoothies, chantilly cream, coffee cream, ice cream, sorbet made with milk, soft cheeses, butter, pudding, custard, creamy sauces and yogurt.
