APDE CAMPOALEGRE NAME: Sofia Montoya, Anggie Quezada, Ana Lucia Guerrero, Diana López 16

IB.
20
SC: LACTOSE INTOLERANCE DATE: 150421 SECTION: IVB
BIOLOGY, IV 9
SCORE:
14

Case Presentation
Pei, a twenty-six year old Asian graduate student in computer science, had been
experiencing occasional discomfort after meals. The discomfort reached a new peak
last Thursday evening about an hour after eating a cheeseburger and a large
chocolate milk shake. Pei spent much of that night in pain. She had abdominal cramps
and diarrhea and also felt sick to her stomach. Pei went to the clinic and saw a doctor
the next day.
The doctor asked Pei a number of questions and noted that Pei's discomfort seemed to
be associated with dining out. Pei told the doctor that on most evenings she cooked for
herself, usually preparing traditional Asian cuisine, and that she seldom experienced
any discomfort after eating at home. Pei only experienced discomfort after dining out,
especially, it seemed, after eating her favorite fast food meal, a double cheese burger
and a chocolate shake. When asked if she used very much milk or cheese when
preparing meals at home, Pei told the doctor that she almost never cooked with any
dairy product.
The doctor suspected that Pei could be lactose intolerant and told Pei that she would
like to have a test performed to verify her suspicion. Pei was able to be tested on that
day because she had not had anything to eat or drink for two hours. At the clinic lab,
Pei was given a lactose rich fluid to drink and had her blood glucose level measured
several times over the course of two hours. Later, her doctor informed Pei that her
blood glucose level had not risen after drinking the lactose rich fluid and that that was
evidence that she was lactose intolerant. The doctor provided Pei with information
about lactose intolerance and discussed with her how she could best alter her diet in
order to avoid any discomfort while still obtaining sufficient calcium. The doctor also
told Pei about various products that contain lactase, the enzyme responsible for
lactose digestion, and assured her that if she used one of those products, she could
probably still have the occasional cheeseburger and chocolate milk shake.

Case Background

Lactose intolerance is the inability to digest significant amounts of lactose. Some

individuals are born lactose intolerant. These individuals lack the ability to produce
lactase from birth. Most individuals that are lactose intolerant, however, become so
gradually as lactase production decreases over time.
There is no cure for lactose intolerance, but treatment is fairly simple. Affected
individuals are instructed to avoid as much lactose as required in order to avoid
discomfort. Different individuals have different levels of intolerance and each affected
person needs to determine through trial and error how much lactose he or she can
tolerate. In addition to dietary control of lactose intolerance, individuals can also use
products that contain lactase.
Watch the following videos
Lactose intolerance evolution
https://www.youtube.com/watch?v=MA9boI1qTuk
LACTOSE INTOLERANCE Pathophysiology,Causes,Signs and symptoms,Treatment:
https://www.youtube.com/watch?v=vjTRAuKbcq0

1. In as complete a manner as possible, describe what type of molecule lactose is and list its
subunits
Lactose is a Disaccharide, it is made up of galactose and glucose linked by a Glycosidic
linkage. It can exist as two isomers, alpha and beta.

2. State where Lactose (β-galactosidase) can be found

Galactosidase is found in bacteria, fungi, and yeasts. In plants, it is mainly found in almonds,
peaches, apples.

3. Describe what type of molecule lactase is and explain its function in the body.
 Lactase is an enzyme and its function is to break lactose into its two constituent sugars: glucose
and galactose so that they can be absorbed into the bloodstream during the digestive process.

4. State what causes the blotting or flatulence in people that is lactose intolerant
People with lactose intolerance do not produce enough of the lactase enzyme to break down
lactose (into galactose and glucose). Instead, undigested lactose stays in the small intestine,
and gets broken down by bacteria, producing methane and causing gas and bloating.

5. Explain, why people that is lactose intolerant might present diarrhea.

People with lactose intolerance are unable to fully digest the lactose in milk in the small
intestine. As a result, they have diarrhea.

6. Describe the test that is used to determine the lactose intolerance in one person.
Drink a liquid with lactose. After 2 hours, your doctor will take a blood sample to measure how
much glucose is in your blood. If your blood glucose level doesn't rise, this means that your
body isn't digesting or absorbing lactose.

7. Explain why measuring glucose after milk ingestion will determine if a person is lactose persistent
or intolerant.
If your glucose levels increase to greater than 20 milligrams per deciliter (mg/dL) after drinking
the lactose, you likely don't have lactose intolerance or a problem with absorption. If your
glucose levels don't rise after drinking the lactose, you may be lactose intolerant since the blood
does not absorb lactose.

8. Do you think the lactase molecule can be reused? Why or why not?
Yes, an enzyme like lactase speeds up a chemical reaction (break down of galactose and
glucose). The products are released from lactase and it returns to its original state, therefore,
the enzyme is ready to act over and over again on lactose.

9. Do you think lactase can break down other sugars besides lactose? Why or why not?
No, lactose is the main naturally occurring sugar found in milk and dairy products. Lactose is
made up of glucose and galactose, two simple sugars that are used directly by the body as a
source of energy. The enzyme lactase breaks down lactose into glucose and galactose.
Although lactose is similar to sucrose, lactase will break down only lactose- due to the shape
of the sugar.
10. Imagine you are a doctor. How would you treat a patient who likes to drink milk but has lactose
intolerance?
Limit eating milk and other dairy products and Include servings of products that contain lactase.

11. Why some people evolve and became lactose tolerant and others did not?
Being lactose intolerant is a genetic problem. People who developed being lactose tolerant
stimulated their body to produce lactase by consuming products that have lactose and lactase in
it. Contrary to the people that remained lactose intolerant, that did not stimulate their body to
produce lactase enzymes by not consuming any lactose.

12. Why do you think scientist believe that being lactose persistence is an advantage?
Lactase persistence (digestion of lactose) is a dominant trait, this gene mutation is exclusive of
environments where there’s access to dairy products and when it is spread a population results
tolerant to lactose. Consuming diary products without any reaction helps to strengthen bones by
the absorption of calcium and the intestine to produce lactase to digest lactose.

13. How did the lactose intolerance test that Pei took provide evidence that she was lactose
intolerant?
Pei´s glucose levels did not rise after drinking the lactose product, this means that she is lactose
intolerant since the blood did not absorb lactose.

14. Explain how lactase can be use in dairy products.

Lactose is a naturally occurring type of sugar found in milk and dairy products. In the intestine, the
enzyme lactase converts lactose into glucose and galactose, two simpler sugars that the body uses as a
source of energy and for various functions.