Lactose intolerance (lactose intolerance)
What is lactose intolerance (lactose intolerance)?
Infants and toddlers usually tolerate dairy products one hundred percent without any problems. Milk contains the ingredient lactose, which is also called lactose. The milk sugar is split by the enzyme lactase.
In adulthood, the ability to optimally digest lactose decreases slowly. This is how the lactose intolerance arises.
The lactose intolerance is not to be confused with an allergy to milk protein. Because a lactose intolerance is just a digestive weakness.
Lactose is broken down in the intestine into the components glucose and galactose with the help of lactase. This digestive enzyme is produced in the small intestine. If it is insufficiently or not produced in the human body, it is called lactose intolerance.
The milk sugar can not be properly digested. The undigested lactose then migrates to other sections of the intestine that are colonized by another type of intestinal bacteria. These intestinal bacteria feed on the undigested lactose. This results in larger amounts of gases and organic acids in the intestine. They also cause water retention in the intestine. This causes violent intestinal movements.
Patients with primary lactase deficiency suffer from neonatal lactase deficiency as a result of metabolic disease. This form of the disease is very rare. The physiological lactase deficiency begins in childhood after weaning. Very slowly, the ability to produce lactase returns.
The secondary lactase deficiency is triggered by a disease such as Crohn's disease or celiac disease. When the disease is cured, lactose intolerance is reduced.
Symptoms, complaints & signsIf the lactose intolerance and the concomitant symptoms in childhood, the causes may be easier to recognize, as if the intolerance due to an increasing lactase deficiency only becomes apparent in adulthood.
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The most common symptoms of lactose intolerance (lactose intolerance) include unexplained abdominal pain, bloating and diarrhea. These occur after the consumption of dairy-containing foods and beverages. The symptoms can occur immediately after the consumption of lactose, but also with delay. How sensitive individual people are depends on the enzyme lactase, with which the milk sugar is metabolized.
The problem is that the symptoms can initially remain inexplicable and diffuse. The organism must inevitably get used to the milk sugar intake. This can make the symptoms less noticeable. They can be "capped" for years and superimposed by other complaints. Symptoms that may appear in this case include an inclination to [[gastrointestinal disorders | gastrointestinal disorders], conspicuous immune problems, sleep disturbances or urinary urgency after consuming milk-containing foods.
Complaints due to lactose intolerance can vary individually. Some people are already reacting to the smallest doses of lactose with severe indigestion. Other people tolerate foods with a low milk sugar content, but those with a higher lactose content do not. It is difficult to always attribute the symptoms to the milk sugar, as it is often hidden under the ingredient "spices" in industrially produced foods.
If the lactose intolerance and the concomitant symptoms in childhood, the causes may be easier to recognize, as if the intolerance due to an increasing lactase deficiency only becomes apparent in adulthood.
What makes lactose intolerance noticeable? After a meal containing lactose, the patients first get a feeling of fullness. This is followed by flatulence and belching. Abdominal pain can be as common as colic, but it does not necessarily have to be so drastic. Nausea and diarrhea can also be caused by lactose intolerance.
There are many gradations in this disease. Some patients may consume small amounts of lactose-containing foods. So this group does not tolerate whole milk, cream or sweet cream butter. Natural yoghurt, buttermilk and sour cream butter, however, are often digested well.
The same goes for cheese. Ripened cheeses are better tolerated than cream cheese, for example. Provided that not too large amounts of these foods are consumed. That the slightly acidified milk products are well tolerated, is ensured by the lactic acid contained therein. She does some of the digestive work.
As a rule of thumb, a group can consume up to one gram of lactose without causing discomfort. Another group can tolerate up to 10 grams of lactose. Only a very small percentage of patients tolerate no lactose at all. For all foods and beverages, as well as for medicines, these patients must be careful that these products do not contain lactose.
As a rule, no particular or life-threatening complications occur with lactose intolerance. The life expectancy of the person affected is not influenced or reduced by lactose intolerance. However, lactose intolerance has a negative effect on the quality of life, so the patient has to do without dairy products.
When taking dairy products it comes to pain in the stomach and stomach and continue to flatulence. Not infrequently, these pain in the long run can lead to depression moods. Especially at night it may come to the pain to sleep problems and thus also to irritability of the patient. A causal treatment of lactose intolerance is not possible.
Those affected must avoid dairy products in their everyday lives or resort to lactose-free products. This can be used to limit most complaints. The intake of supportive medications can relieve and limit the symptoms. Special complications or other complaints do not usually occur. Furthermore, in some cases, patients may need supplements to get the missing nutrients from dairy products. However, life expectancy is not adversely affected by lactose intolerance.
When should you go to the doctor?
Constant indigestion must always be examined by a doctor. Chronic intestinal problems reduce the well-being and can cause secondary diseases, which are associated with further complaints. Therefore, a doctor must be turned on if the symptoms described occur again or even persist permanently. If it comes in connection with an intolerance to malnutrition and weight problems, consult a doctor's office or clinic immediately. If there are risk factors such as the regular use of medication (especially painkillers and antibiotics), illnesses or surgical interventions and an unhealthy diet, a visit to a doctor is also recommended.
Also missing movement and stress are typical triggers of an incompatibility. Persons to whom the above factors apply must seek medical advice. In addition, depending on the cause of a nutritionist or therapist should be consulted. Additional contact persons are the gastroenterologist, internist or allergist. The physician can diagnose lactose intolerance and suggest appropriate therapy to the patient. If this occurs early, chronic gastrointestinal complaints can usually be avoided.
Treatment & Therapy
The treatment of lactose intolerance is individually different. There is even the possibility of supplying the missing enzyme by means of suitable preparations from the pharmacy. However, tablets containing the enzyme lactase are not reimbursed by the health insurance companies.
It makes the most sense to change the diet and adapt to the respective lactose intolerance. It is not advisable to abstain from dairy products in general. Because they are important building blocks in the diet, as they provide the important for bone structure calcium.
So it remains to be clarified to what extent lactose must actually be dispensed with or whether smaller amounts are tolerated. If patients are only able to consume very small amounts of milk sugar and therefore have to restrict their milk products, it is recommended to take a preparation with the enzyme lactase.
Outlook & Forecast
Lactose intolerance is not a life-threatening disease. Affected persons must expect no limitations in life expectancy or quality of life. However, lactose-containing products must be permanently eliminated. In addition, sufferers should regularly consult the gastroenterologist or family doctor. The physician can monitor the course of the disease and call appropriate remedies for complaints. This is especially useful for chronic complaints that can not be alleviated by the absence of appropriate foods alone.
If the symptoms persist despite all measures, it may be due to another cause. Then a thorough medical examination is recommended. The physician can give an accurate prognosis and give further tips on how to design everyday life with the disease. A mild secondary lactose intolerance can often be cured by slowly increasing the consumption of products containing lactose.
Innate lactose intolerance exists throughout life. The enzyme disorder must be treated permanently by not using appropriate foods. Otherwise, major complications may occur that significantly affect well-being. In children, lactose intolerance can cause life-threatening symptoms. The course depends on whether the enzyme disorder is detected early and what measures are taken. With early treatment by a specialist, the prognosis is generally positive.
To prevent discomfort, patients can select preventative non-dairy foods. On the ingredient lists of the products is declared whether a food that does not contain milk, was really fed no milk sugar. Unfortunately, there is no other prevention, for example against the actual weakness of the digestive system.
Follow-up often takes place in serious illnesses that can recur after a successful procedure. Cancers are a classic example. In contrast, lactose intolerance is permanent. She does not disappear. In addition, it does not run life-threatening. The aftercare has a different orientation in lactose intolerance: The patient should realize a life free of complaints in his everyday life.
This is best done by avoiding foods containing a large amount of lactose. The follow-up is actually a medical accompaniment. Often, semi-annual mandatory appointments are agreed, in which the progress of a disease is documented. During this sometimes complex investigations take place, which allow statements about internal organs.
In the case of lactose intolerance, however, the use of doctors and therapists is limited to a mere transfer of knowledge. The doctor will inform his patient about his diagnosis and may recommend nutritional advice. The implementation of the information provided then falls under the responsibility of the patient.
The use of certain medications also prevents the typical signs. Patients may ask their doctor for a prescription for any medical condition. Especially in case of uncertainty about the sugar content in food and drinks, a use may be useful.
You can do that yourself
Those who suffer from lactose intolerance should change their diet. It is important to find out whether milk sugar must be completely eliminated or whether a low-lactose diet is sufficient. Frequently affected people can take small amounts of lactose without any complaints.
To maintain a balanced diet despite the absence of dairy products, it makes sense to contact a nutritionist. In addition to the family doctor, he can answer questions and rule out malnutrition. Because by the general renouncement of milk-containing food, it can come to a lack of calcium, which is important for the bone structure. To counter this, it helps green to eat high-calorie vegetables, such as broccoli or fennel.
A complete waiver of dairy products is not necessary. Supermarkets offer a variety of labeled lactose-free products. The lactase enzyme is added to the milk, which ensures that the milk sugar is split and thus easier to digest. It is also possible to switch to vegetable substitutes, such as soy or oat milk. It is also possible to take lactase preparations for dairy foods. These allow lactose-containing foods to digest easily. The preparations are available in the form of tablets or powders, over-the-counter in pharmacies, drugstores or supermarkets. It is important to pay attention to the correct dosage and not to consume too little of the enzyme, otherwise the effect will be off.