Helicobacter pylori Lactose intolerance Bacterial overgrowth Exocrine Pancreatic Insufficiency

 

HEALTH SECTION / LACTOSE INTOLERANCE

 

What is it?

Lactose intolerance is an intestinal condition resulting from the organism producing little or no lactase enzyme, which is responsible for breaking lactose (natural sugar in milk) and separating it into its constituent monosaccharides (glucose and galactose are the most common).

So when the lack of lactase prevents the organism from assimilating lactose, a representative clinical picture results.

 

Symptoms

The most common symptoms associated with lactose intolerance are:

  • Abdominal pain.
  • Gases.
  • Diarrhea.
  • Inflammation.
  • Cramps.

 

Types of lactose intolerance

  • Primary intolerance: It is a genetically determined intolerance in which there is an intestinal lactase reduction in post-childhood ages.
  • Secondary or acquired intolerance: This is an acquired condition, secondary to, intestinal resections, diseases of the intestinal mucous (viral infections, gastroenteritis or chemotherapy), taking medications (NSAIDs or antibiotics). These aggressions reduce the lactose hydrolysis capacity.

 

Recommended treatment

For people with this type of intolerance, they are strongly recommended to take products that are lactose free or which have low lactose content so their discomfort will be greatly reduced.

Lactose replacement therapy is also recommended.

 

Diagnosis

Three techniques are used to detect this pathology:

 

  • Breath Test to diagnose Lactose Intolerance: is a non-invasive test and easy to perform breath. Measure is based on H2 and CH4 production in the breath after ingestion of lactose, for a certain time. The measurement of CH4 is done because about 30-40% of the population is not producing H2 (H2 in CH4 transform by methanogenic bacteria).
  • Lactose tolerance test: is a lactose in blood analysis, three blood samples are taken at an interval of 2 hours to measure the increase of glucose.
  • Small intestine biopsy: analysis of samples from a biopsy of the small intestine. This is to introduce an endoscope through the mouth to take the test sample.

 

The lactose intolerance should not be confused with irritable bowel syndrome and a differential diagnosis is required because the symptoms may be identical. The hydrogen breath test helps to differentiate them.

A distinction must also be made between lactose intolerance and allergies to the components in milk. In this latter case, however, skin and respiratory symptoms usually occur.

References

  • Utilidad de la cuantificación del metano en aire espirado en la intolerancia a la lactosa y en el sobrecrecimiento bacteriano. Conchello Monleon R, Rodríguez Sanz ML, Ros Arnal I, Ros Mara L. Unidad de Gastroenterología y Nutrición Pediátrica. Hospital Miguel Servet. Zaragoza.
  • Bases físicas del test de hidrógeno. M. Fernández Bermejo. Médico Residente. Servicio de Medicina Digestiva. Hospital de la Princesa. Madrid.

 

Consenso Internacional

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