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Food intolerances explained
continued from page 1
Lactose intolerance
Lactose intolerance is relatively common and is due to a metabolic deficiency of an enzyme, lactase, that is needed to digest lactose before it can be absorbed. Lactase is released from the lining of the small intestine and breaks lactose down into two sugars, glucose and galactose, which are immediately absorbed into the blood stream. Lactase deficiency leads to symptoms that can include:
Lactase deficiency can be present from birth (primary lactase deficiency) or can result temporarily after a bout of gastro-enteritis (secondary lactase deficiency).
Lactose deficiency is sometimes diagnosed by taking a lactose tolerance test. A solution containing 50 grams of lactose sugar is drunk and blood samples taken at intervals over the next two hours. A more reliable test is to measure breath hydrogen levels after a known amount of lactose is consumed. In normal conditions, the hydrogen content of the breath does not increase as all lactose is absorbed. If there is a deficiency of lactase however, the sugar reaches the colon where it is fermented by bowel bacteria to produce an increase in breath hydrogen content after 90 minutes. Alternatively, a small bowel sample (jejunal biopsy) can be taken which will confirm the lack of lactase enzyme.
Treatment involves following a lactose elimination diet in which soya or low lactose milk products used in place of cows' milk products.
Lactose content of different milks
Lactose (g) per glass
Full fat cows' milk 9.3 g
Skimmed cows' milk 9.8 g
Low lactose cows' milk 0.5 g
Goats' milk 8.6 g
Sheep' milk 9.9 g
Soya milk 0
Yoghurt made from cows' milk has a low lactose content as bacterial fermentation breaks the lactose down.
Lactose intolerance
Lactose intolerance is relatively common and is due to a metabolic deficiency of an enzyme, lactase, that is needed to digest lactose before it can be absorbed. Lactase is released from the lining of the small intestine and breaks lactose down into two sugars, glucose and galactose, which are immediately absorbed into the blood stream. Lactase deficiency leads to symptoms that can include:
- bloating and wind
- audible bowel sounds (borborygmi)
- abdominal pain
- diarrhoea
Lactase deficiency can be present from birth (primary lactase deficiency) or can result temporarily after a bout of gastro-enteritis (secondary lactase deficiency).
Lactose deficiency is sometimes diagnosed by taking a lactose tolerance test. A solution containing 50 grams of lactose sugar is drunk and blood samples taken at intervals over the next two hours. A more reliable test is to measure breath hydrogen levels after a known amount of lactose is consumed. In normal conditions, the hydrogen content of the breath does not increase as all lactose is absorbed. If there is a deficiency of lactase however, the sugar reaches the colon where it is fermented by bowel bacteria to produce an increase in breath hydrogen content after 90 minutes. Alternatively, a small bowel sample (jejunal biopsy) can be taken which will confirm the lack of lactase enzyme.
Treatment involves following a lactose elimination diet in which soya or low lactose milk products used in place of cows' milk products.
Lactose content of different milks
Lactose (g) per glass
Yoghurt made from cows' milk has a low lactose content as bacterial fermentation breaks the lactose down.
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