Digestion: Lactose Intolerance

1. What is Lactose intolerance?

Lactose intolerance is the inability to metabolize (break down) the

substance lactose because of the insufficient amount of the enzyme
lactase.

2. What are the Symptoms and Causes?

Lactose is a disaccharide, which means it’s composed of two sugars bound

together. In order for lactose to be absorbed by the body, it must be able
to split it up into smaller sugars through the enzyme lactase. If there is low
levels of lactase splitting will not occur. The lactose is then fermented by
the bacteria by the large instestine.

Symptoms include:

• Diarrhoea

• Stomach Rumbling

• Nausea

• Abdominal Colic

3. Which enzyme is in short supply?

Lactase

4. How is it diagnosed?

Hydrogen Breath Test – This is the most convenient and reliable way for
lactose intolerant. 25 grams of milk is ingested in the body along with
water after an overnight fast. For a lactose intolerant person, the lactose
travels to the colon where it is split and hydrogen is produced in the
process, where it travels through your blood to your lungs, and is excreted
through the breath. Small breath tests are taken for hydrogen in 10-15
minute intervals between 3-5 hours. The greater the amount of hydrogen
excreted, the greater the deficiency.

Blood Glucose Test – For the blood glucose test, 0.75-1.5 gm is normally
ingested per kg of body weight. After an overnight fast, serial blood
samples are taken. If glucose levels rise higher than 25mg/100ml, it
means the lactose has been split in the intestine and the glucose has been
absorbed into the blood. This says Lactase Levels are normal. However, it
requires multiple samples of blood and can be inaccurate.

Stool Acidity Test - During the stool acidity test, infants and very young
children are given lactose to drink. With normal tolerance to lactose, all of
the lactose is digested and absorbed in the small intestine. In individuals
who are lactose intolerant, some or all of the lactose is not digested and
absorbed in the small intestine and reaches the colon. Through the action
of the colonic bacteria, the stool becomes acid. The acidity of stools that
are passed after ingestion of the lactose then is measured. If the stool
becomes acid, the individual is intolerant of lactose.

5. Why yoghurts are eaten in lactase deficient areas of the world?

Yoghurts are eaten in lactase deficient areas of the world because as well
as the yoghurt containing lactose, it also contains lactase as well so the
body does not need to produce it.

6. Which animal milk has the most lactose? Is it human milk?

Human milk has the highest lactose percentage at around 9%.

7. Does drinking goat milk reduce the symptoms?

Although goats milk contains lactose, many lactose intolerant people

can drink goats milk partly because it is easier to absorb by the body.
Therefore there is less residue in the colon reducing the symptoms.

8. What is hidden lactose?

Lactose may be added to certain foods, this is called hidden lactose. For
example, bread, processes cereals, margarine, salad dressings.

9. Why is lactose intolerance a very serious condition in babies?

Lactose Intolerance is a very serious condition for babies because the

baby depends on the mother’s breast milk because it contains vital
antibodies for the baby since there immune system is not fully
 developed. Breast milk contains lactose so the inability to take the
mother’s breast milk may lead to serious illnesses.

10.Most adults in the world are lactose intolerant to a degree.