BY WANIYA AHMED
Lactose intolerance is a digestive disorder and in that case body is unable to digest lactose this phenomenon is also known as malabsorption.
Lactose intolerance is a physiological condition which indicates the imbalance amount of indigestible lactose and the capability of lactase to hydrolyze lactose (disaccharide), the main sugar present in dairy products such as; milk, yogurt, butter, cheese, cream, etc. Patients should be educated that symptoms are not caused by allergic reactions to milk protein, but rather by an inability to breakdown and absorb milk sugars.
MECHANISM OF ENZYME ON LACTOSE SUGAR:
Lactase aka lactase-phlorizin hydrolase enzyme is needed to metabolize lactose sugar. The lining of small intestine is called villi. Villi contains hundreds of intestinal cells known as enterocytes. Enterocytes are aligned in a finger like projection termed as microvilli. Microvilli helps in the assimilation of nutrients from food which later becomes the part of bloodstream. The gene responsible for the production of lactase enzyme is expressed exclusively in the enterocytes. The minute formed enzyme makes its way to the cell surface along the cells microvilli, the lactase enzyme splits and hydrolyzes dietary lactose into glucose and galactose for the transportation through the cell membrane. Glucose is eventually utilized as a source of energy and galactose converts into the component of glycolipids and glycoproteins. Unabsorbed lactose keeps moving down in G.I tract and enter into large intestine where lactose is broken down or fermented by gut flora (microbes), which releases a lot of gas and short chains of fatty acids, both unabsorbed products rise the osmotic pressure which attracts water in bowels so water flows in and this influx of water leads to diarrhea. Primary lactose intolerance, a common type in which plenty of lactase is produced to cope the necessity of infants. By the age as children replace milk with other food, lactase production normally decreases but still sufficient to digest the amount of dairy in typical adult diet.
Secondary lactose intolerance takes place, as soon as your small intestine decreases the lactase production after an illness, injury or surgery involving your small intestine. Lactose intolerance can be congenital (extremely rare disorder) meaning infants would be deficient from birth. This is an autosomal recessive disorder where infants are unable to digest lactose and have trouble with breastmilk and develop diarrhea by birth.
SYMPTOMS AND DIAGNOSIS
Symptoms tend to occur about 30 minutes to 2 hours after consumption food that contain lactose. Signs and Symptoms of lactose intolerance includes; abdominal distention, nausea, bloating, gas, flatulence, abdominal cramping, and ultimately diarrhea.
Few test can be done for the assurance of lactose intolerance base on the symptoms mentioned above such as; lactose tolerance test, Hydrogen breath test, breath hydrogen levels are measured before and after the intake of lactose. Stool acidity test, high pH levels in stool leads evidence of lactose intolerance.
PRECAUTIONS AND TREATMENTS:
There are ways to overcome with the problem of lactose intolerance by limiting the consumption of dairy products from regular diet, use of lactose-free products such as; almond milk, oat milk, coconut-based yoghurts and cheeses, etc., intake of probiotics may help relieve the symptoms of lactose intolerance.
CALCIUM AS AN IMPORTANT SOURCE:
Calcium is important for bones, teeth, and too regulates muscle contractions. By eliminating milk products from daily people require calcium supplementation to prevent the effects of osteoporosis. Combined calcium and vitamin D supplements helps to restore nutrients substitute to dairy products.
Calcium levels can stay balanced by including, Oranges, spinach, broccoli, calcium-fortified products such as breads, nuts, etc. along with your diet.
CONCLUSION:
Dairy products are the cause of inappropriate gastrointestinal symptoms in people with lactose intolerance, they consume lactose-free milk and other dairy products. A carefully chosen diet is the key to reduce symptoms.
ARTICLE WRITTEN BY: WANIYA AHMED
UNDER SUPERVISION OF: DR. NOMAN KHAN
DEPT. OF PHYSIOLOGY, UNIVERSITY OF KARACHI
