LACTOSE INTOLERANCE

PRESENTOR : DR.KARAN R RAWAT

Lactose

Lactose 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.

Cream

Yoghurt

Cheese

Processed foods

Stuffings

Salad dressings etc.

Lactose intolerance

Lactose 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 intolerance

Lactose 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.

Symptoms

Abdominal bloating and cramps

Flatulence

Diarrhoea

Nausea

Borborygmi (rumbling stomach)

Vomiting (particularly in adolescents).

Types of lactase deficiency

Primary 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.

Diagnosis

Dietary 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.

Misdiagnosis

Irritable bowel syndrome

Crohn's disease

Food poisoning

Gastroenteritis.

Celiac disease.

Management

Avoiding lactose-containing products

Alternative 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.