LACTOSE INTOLERANCE

LactoseLactose is a disaccharide of β-D-

galactose and β-D-glucose in β(1,4) linkage.

Human milk contains 200mmol/lit of lactose.

It is digested by enzyme lactase to form glucose and galactose in the brush border of the intestine.

Lactose containing food stuffs

Fresh, skimmed , non fat and condensed milk.

CreamYoghurtCheeseProcessed foodsStuffingsSalad dressings etc.

Lactose intoleranceLactose intolerance, also

called lactase deficiency or hypolactasia, is the inability to digest and metabolize lactose, a sugar found in milk.

Lactose intolerance is not an allergy because it is not an immune response but caused by lactase deficiency.

Lactose intoleranceLactose intolerance can occur in

any age group or population. However, people of African,

Jewish, Hispanic, Asian, Middle Eastern and Native American descent, Caucasians are at risk for developing lactose intolerance.

SymptomsAbdominal bloating and crampsFlatulenceDiarrhoeaNauseaBorborygmi (rumbling stomach)Vomiting (particularly in

adolescents).

Types of lactase deficiencyPrimary lactase deficiency is a

genetically determined absence or decrease in the enzyme is noted.

Jejunal morphology is normal. In non caucasian groups,

primary lactase deficiency is abnormal in adulthood.

Secondary lactase deficiency

Secondary, acquired, or transient lactase deficiency is due to the small intestinal mucosal disease, abnormalities of brush border cells and transport processes.

It is often associated with celiac sprue.

Congenital lactase deficiency

Congenital lactase deficiency is a very rare, autosomal recessive genetic disorder that prevents lactase expression from the first feed.

Congenital lactose intolerance is serioue disorder in which the infants may fail to thrive unless given lactose free formula feed.

DiagnosisDietary history of the patient who

are complaining flatulance , abdominal pain , diarrhoea.

Familial history of the patient.Check whether the patient has

underwent partial gastrectomy and other related procedures.

Tests – stool acidity test, hydrogen breath tests.

MisdiagnosisIrritable bowel syndromeCrohn's diseaseFood poisoning Gastroenteritis. Celiac disease.

ManagementAvoiding lactose-containing

productsAlternative products such as

Plant-based milks and derivatives are inherently lactose free: soy milk, rice milk, almond milk, hazelnut milk, oat milk, hemp milk, peanut milk, horchata.

THANK YOU