Lactose intolerance

What to look for to recognize the characteristic symptoms of lactose intolerance? Lactose-free milk is becoming more and more common in stores. Does this mean that you should buy them to take better care of your health?

What is lactose?

Lactose is a disaccharide consisting of D-glucose and D-galaktose. It is the sugar found in milk and dairy products. It is also sometimes added by producers to other food or pharmaceutical products. Currently, you can see an increasing number of lactose-free dairy products in stores. Is it worth using them to improve our health? What are the symptoms of lactose intolerance?

What is lactose intolerance?

Each type of food consumed by humans must be broken down into smaller parts. In the next stage, the small intestine absorbs them into the bloodstream so that they can fulfill their biological functions. The same happens with lactose, which must be broken down into simple sugars. An essential element of this breakdown is an enzyme called lactase. It is produced by the epithelial cells of the small intestine and then stored within the borders of the brush border microvilli.

Lactose intolerance is a disorder resulting from a deficiency or complete absence of lactase in the small intestine. When lactose cannot be digested and absorbed, excess lactose passes into the small intestine and even into the large intestine. There, it becomes a source of food for microorganisms. As a result of bacterial fermentation, methane (CH4) and hydrogen (H2) are produced.

Lactose intolerance symptoms

Products produced with lactose digestion disorder are responsible for the feeling of fullness, gas, colic and overflow. Lactic acid formed in the fermentation process, as well as undigested lactose, change the osmotic pressure, as a result of which water flows into the intestine. This explains another symptom of intolerance, which is diarrhea. In extreme situations, these symptoms make it difficult to absorb other nutrients, i.e. proteins and fats. if you have noticed that you have similar symptoms after consuming products containing lactose, you should consider diagnostics.

Types of lactose intolerance

Three types of clinical lactose intolerance due to lactase deficiency are currently known.

• Alactasia, or congenital lactase deficiency. It is rare but dangerous. This type of disease has a genetic basis. The first symptoms characteristic of intolerance appear already when the newborn consumes breast milk or modified milk for the first time. This is due to the absence of the enzyme from birth. People with alactasia are forced to follow a lactose-free diet throughout their lives. Even small amounts of this sugar threaten health and can lead to death.
• Secondary lactase deficiency occurs when intestinal microvilli have been damaged due to various factors. These include infections - bacterial, rotavirus, helminth invasions, the influence of iatrogenic factors, e.g. alcohol, some non-steroidal drugs, acetylsalicylic acid, antibiotics and the effects of malnutrition, Crohn's disease, cystic fibrosis and other diseases. As a result of cavities and damage to the intestine, the surface area that secretes and accumulates lactase decreases. During this period, a lactose-free diet should be followed and the indirect cause of the enzyme deficiency should be eliminated. After regeneration of the damaged intestinal epithelium, you can return to the milk diet.
• Primary lactase deficiency - adult-type hypolactasia (ATH). In this case, people are born with normal lactase activity and do not experience symptoms of intolerance after consuming milk. However, a large group of people, along with ontogenetic development, begin to produce smaller amount of lactase. Lactase synthesis is conditioned by lactase gene mutations (LCT).

Lactose intolerance test

There are several methods of detecting lactose intolerance, but none of the tests clearly confirms or excludes the presence of the disease.

• small intestine biopsy - allows for the precise determination of lactase concentration in a given cells
• oral lactose tolerance test - after giving the patient lactose, its concentration in the blood is measured several times
• hydrogen breath test – measurements of hydrogen concentration in the exhaled air every 20 minutes for 2 hours after getting lactose
• molecular tests - they allow the detection of genetically determined lactose intolerance

There is no need to consume lactose-free products if you are not diagnosed with lactose intolerance and do not experience symptoms of lactose intolerance. However, if they occur, it is very important to use a balanced elimination diet.