About 90 percent of the world’s population suffers from lactose intolerance or intolerance to milk sugar. In the countries of Central Europe, fewer people suffer from lactose intolerance. Here you will find only about 10 to 20 percent of the population with lactose intolerance.
What is lactose intolerance (milk sugar intolerance)?
Babies and small children usually tolerate milk products one hundred percent without any problems. Milk contains lactose, also known as milk sugar. The lactose is broken down by the enzyme lactase. See AbbreviationFinder for abbreviations related to Lactose Intolerance.
In adulthood, the ability to optimally digest lactose slowly decreases. This is how lactose intolerance develops.
Lactose intolerance should not be confused with an allergy to milk protein. Because lactose intolerance is just a digestive weakness.
Causes
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 produced insufficiently or not at all in the human body, this is referred to as lactose intolerance.
The lactose can no longer be properly digested. The undigested lactose then migrates to other parts of the intestine that are colonized with a different type of intestinal bacteria. These intestinal bacteria feed on the undigested lactose. This creates larger amounts of gases and organic acids in the intestine. They also cause water retention in the intestines. This causes violent bowel movements.
In primary lactase deficiency, patients suffer from neonatal lactase deficiency as a result of a metabolic disease. This form of the disease is very rare. The physiological lactase deficiency begins in childhood after weaning. The ability to produce lactase then slowly decreases.
The secondary lactase deficiency is triggered by a disease such as Crohn’s disease or celiac disease. When the disease has healed, the lactose intolerance recedes.
Symptoms, Ailments & Signs
If lactose intolerance and the accompanying symptoms occur in childhood, the causes may be easier to identify than if the intolerance only becomes apparent in adulthood due to an increasing lactase deficiency.
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The most common symptoms of lactose intolerance (milk sugar intolerance) include unexplained abdominal pain, gas, and diarrhea. These occur after consuming foods and drinks containing lactose. The symptoms can appear immediately after consuming milk sugar, but also with a delay. How sensitive individual people are depends on the enzyme lactase, which is used to metabolize milk sugar.
The problem is that the symptoms can initially remain inexplicable and diffuse. The organism has to get used to the milk sugar supply. As a result, the symptoms can be less noticeable. They can be “capped” for years and overlaid by other complaints. In this case, the symptoms that occur can include a tendency to [[gastrointestinal disorders|gastrointestinal disorders, noticeable immune problems, sleep disorders or the urge to urinate after consuming foods containing lactose.
Symptoms of lactose intolerance can vary from person to person. Some people react to even the smallest doses of lactose with severe digestive problems. Other people tolerate foods with a low lactose content well, but not those with a higher lactose content. It is difficult to always attribute the symptoms that occur to lactose, as this is often hidden under the ingredient “spices” in industrially produced foods.
If lactose intolerance and the accompanying symptoms occur in childhood, the causes may be easier to identify than if the intolerance only becomes apparent in adulthood due to an increasing lactase deficiency.
course of the disease
What makes lactose intolerance noticeable? After a meal containing lactose, patients initially get a feeling of fullness. Bloating and belching follow. Abdominal pain can develop up to colic, but this does not necessarily have to be so drastic. Nausea and diarrhea can also be caused by lactose intolerance.
There are many degrees of this disease. Some patients can eat small amounts of foods containing lactose. This group does not tolerate whole milk, cream or sweet cream butter. Plain yoghurt, buttermilk and sour cream butter, on the other hand, are often digested well.
The same goes for cheese. Mature cheeses are better tolerated than cream cheese, for example. Provided that excessive amounts of these foods are not eaten. The lactic acid they contain ensures that the slightly acidified milk products are well tolerated. It takes over part of the digestive work.
As a rule of thumb, a group can consume up to one gram of lactose without experiencing any symptoms. Another group can tolerate up to 10 grams of milk sugar. Only a very small percentage of patients cannot tolerate lactose at all. These patients must ensure that all foods, beverages and medications do not contain lactose.
Complications
As a rule, there are no special or life-threatening complications with lactose intolerance. The life expectancy of the affected person is not affected or reduced due to the lactose intolerance. However, lactose intolerance has a negative effect on the quality of life, so that the patient has to do without dairy products.
When ingesting dairy products, this leads to pain in the stomach and stomach and also to flatulence. Not infrequently, this pain can also lead to depression in the long run. Especially at night, the pain can cause sleep problems and thus irritability in the patient. However, 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 limit most complaints. Taking supportive medication can also relieve and limit the symptoms. Special complications or other complaints do not usually occur. Furthermore, in some cases, patients are dependent on supplements to obtain the missing nutrients from dairy products. However, life expectancy is not negatively affected by lactose intolerance.
When should you go to the doctor?
Persistent digestive problems must always be examined by a doctor. Chronic intestinal problems reduce well-being and can cause secondary diseases that are associated with other complaints. Therefore, a doctor must be consulted if the symptoms described recur or even persist. If malnutrition and weight problems occur in connection with an intolerance, a doctor’s practice or clinic should be consulted immediately. If there are risk factors such as the regular intake of medication (especially painkillers and antibiotics), illnesses or surgical procedures and an unhealthy diet, a doctor’s visit is also recommended.
Lack of exercise and stress are also typical triggers of intolerance. Persons to whom the above factors apply must seek medical advice. Depending on the cause, a nutritionist or therapist should also be consulted. Additional contacts are the gastroenterologist, internist or allergist. The doctor can diagnose the lactose intolerance and suggest a suitable therapy for the patient. If this happens early, chronic gastrointestinal complaints can usually be avoided.
Treatment & Therapy
The treatment of lactose intolerance varies from person to person. There is the possibility of supplying the missing enzyme with suitable preparations from the pharmacy. However, tablets containing the enzyme lactase are not reimbursed by health insurance companies.
It makes the most sense to change your diet and adapt it to your lactose intolerance. Avoiding dairy products in general is not advisable. Because they are important building blocks in nutrition, as they provide the calcium that is important for bone structure.
So it remains to be clarified to what extent lactose actually has to be avoided or whether smaller amounts can be tolerated. If patients can only consume very small amounts of lactose and therefore have to limit their consumption of milk products, it is advisable to take a preparation with the enzyme lactase.
Outlook & Forecast
Lactose intolerance is not a life-threatening condition. Those affected do not have to reckon with any restrictions in life expectancy or quality of life. However, products containing lactose must be avoided permanently. In addition, those affected should regularly consult the gastroenterologist or family doctor. The doctor can monitor the course of the disease and name suitable countermeasures in the event of symptoms. This is particularly useful for chronic complaints that cannot be alleviated by simply not eating the right foods.
If the symptoms persist despite all measures, there may be another cause. A detailed medical examination is then recommended. The doctor can give an exact prognosis and give other tips on how to manage everyday life with the disease. A mild secondary lactose intolerance can often be cured by slowly increasing the consumption of products containing lactose.
Congenital lactose intolerance persists throughout life. The enzyme disorder must be treated permanently by avoiding the corresponding foods. Otherwise, major complications may arise 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.
Prevention
In order to avoid any symptoms, patients can preventively select dairy-free foods. The lists of ingredients of the products state whether a food that does not contain milk really does not contain any lactose. Unfortunately, there is no other form of prevention, for example against the actual digestive weakness.
Aftercare
Follow-up care is often provided for serious illnesses that may recur after a successful procedure. Cancer is a classic example. Lactose intolerance, on the other hand, is permanent. She doesn’t go away. In addition, it is not life-threatening. Follow-up care for lactose intolerance has a different focus: the patient should be able to lead a symptom-free life in his everyday life.
This is best done by avoiding foods with a large proportion of lactose. Follow-up care is actually medical support. Mandatory appointments are often made every six months, in which the progress of an illness is documented. During this, sometimes complex examinations take place, which allow statements to be made about internal organs.
In the case of lactose intolerance, on the other hand, the use of doctors and therapists is limited to pure knowledge transfer. The doctor will educate the patient about their diagnosis and may recommend nutritional counseling. It is then the patient’s responsibility to implement the information provided.
Taking certain medications also prevents the typical symptoms. Patients can ask their doctor for a prescription against any ailments. Use can make sense, especially when there is uncertainty about the sugar content in food and drinks.
You can do that yourself
Anyone suffering from lactose intolerance should change their diet. It is important to find out whether milk sugar has to be completely avoided or whether a low-lactose diet is sufficient. Because affected people can often consume small amounts of lactose without symptoms.
In order to have a balanced diet despite not having dairy products, it makes sense to get in touch with a nutritionist. In addition to the family doctor, he can answer questions and rule out malnutrition. Because the general renunciation of milk-containing dishes can lead to a lack of calcium, which is important for bone structure. To counteract this, it helps to eat green, calcium-rich vegetables, such as broccoli or fennel.
However, it is not necessary to completely avoid dairy products. Supermarkets offer a variety of labeled lactose-free products. The enzyme lactase is added to the milk, which ensures that the lactose is broken down and thus becomes easier to digest. It is also possible to switch to plant-based substitutes such as soy or oat milk. It is also possible to take lactase preparations with foods containing milk. These allow lactose-containing foods to be digested without any problems. The preparations are available in the form of tablets or powders, without a prescription in pharmacies, drugstores or supermarkets. It is important to observe the correct dosage and not to take too little of the enzyme, otherwise the effect will be lost.