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What does lactose intolerance mean and how does it manifest in adults?

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The human body is an incredibly complex mechanism. And, unfortunately, it does not always work like a clock, as a result of which various problems may arise. One of them is lactose intolerance. And what is it, how does it manifest itself?

Lactose is a milk carbohydrate called milk sugar. In other words, it is a sugar molecule consisting of two other components: galactose and glucose. It is formed in the mammary glands of all mammals and is found exclusively in milk.

What is lactose for? It is incredibly useful, as it promotes the absorption in the intestine of a variety of mineral substances contained in food, for example, calcium. In addition, it is necessary for the reproduction of beneficial lactic acid bacteria, which are necessary for normal functioning of the immune system. But in order for lactose to fulfill all its functions, it must be properly and fully digested, and this is possible, unfortunately, not always.

The essence of intolerance

What is lactose intolerance? To understand this, it is necessary to understand a little the essence of the processes occurring in the intestine. In general, lactose must be broken down in its walls into galactose and glucose, which it consists of. And it becomes possible thanks to a special enzyme produced by the body - lactase. If it is not enough, or it is not synthesized at all, then lactose cannot be absorbed, and its intolerance occurs.

There are two main types of lactose intolerance: primary and secondary. The first appears as an independent state and can be innate. Secondary intolerance is due to the influence of negative factors and can develop at almost any age.

The main causes of lactose intolerance:

  • Genetic predisposition. A certain gene is responsible for the production of the lactase enzyme responsible for the breakdown of lactose. And as a result of some genetic mutations lactase deficiency may occur, which will lead to lactose intolerance. In general, the amount of enzyme will inevitably decrease with age (up to about 12-13 years old), and this is normal. In adults, this substance is produced in minimal amounts, but still sufficient to fully digest milk (provided it is properly consumed). But for some, the ability to synthesize lactase disappears almost completely.
  • Severe allergies, especially to cow's milk protein.
  • Transferred acute intestinal infections, especially with their improper treatment. Such diseases can lead to severe irritation and even partial destruction of the membranes of the intestinal walls, in which lactase is produced.
  • Celiac disease This is a disease in which certain types of food proteins are not tolerated, for example, gluten, which is contained in many cereals. Such proteins also damage the villi of the small intestine, with the result that lactase cannot be produced in sufficient quantities.

Manifestations

The manifestations of lactose intolerance may be different. And even for one person, the symptoms can manifest themselves in different ways, since they depend on the amount of milk sugar that has entered the body, on the specific products used that contain it, on dietary habits and on some other factors.

Usually, the first manifestations begin to bother the patient about an hour or two after consuming milk and other products containing lactose, that is, when milk sugar reaches the intestine.

In a child (especially an infant), signs can be observed literally within a few minutes after eating, which is associated with the age characteristics of the digestive process and the failure of the gastrointestinal tract.

The main symptoms of lactose intolerance:

  • Increased flatulence, flatulence.
  • Abdominal pains that are cramping in nature.
  • Diarrhea (diarrhea).
  • Boiling, rumbling in the stomach.
  • Vomiting. It occurs less frequently, but it can still appear from time to time, especially when consuming large quantities of products containing lactose.
  • Some have constipation.
  • Bloating.
  • In infants, almost immediately after feeding, capriciousness and anxiety may appear. Many babies start crying, straining. Also characteristic signs are abundant and frequent regurgitation, rumbling in the abdomen, colic.
  • Since lactose is necessary for the reproduction of beneficial bacteria responsible for the functioning of the immune system, frequent symptoms of intolerance may be frequent colds, general weakness, fatigue, drowsiness.

Diagnostics

Often lactose intolerance (lactase deficiency) is confused with allergy to cow's milk protein or even to other proteins. And in order to make an accurate diagnosis, the doctor may advise you to follow a certain diet and keep a food diary in which the food eaten, its quantity, as well as the symptoms that occur after meals and the time of their occurrence will be noted.

There are more accurate specialized medical diagnostic methods. The patient is asked to consume 50 milliliters of lactose. After that, some measurements are taken. Thus, the level of hydrogen in the air exhaled by a person and the sugar content in the blood are determined.

The fact is that if lactase is not enough, then lactose does not break down in the small intestine, as it should be normal, and enters the fat, where it begins to be processed by bacteria. During such processing, hydrogen is formed that enters the blood and exits from the lungs. But glucose in this case is formed in minimal quantities.

How to treat?

Primary intolerance to lactose cannot be cured completely, but it is completely possible to live with it fully. But secondary intolerance can go away independently after the elimination of negative factors of influence or their consequences.

The first and most important stage of treatment is proper nutrition. The diet should be prepared by the doctor and taking into account the characteristics of the patient. For example, some can properly assimilate small amounts of milk, others painlessly use dairy products, as they are transformed into milk sugar by bacteria into lactic acid.

In addition, in the course of research it was found that even people suffering from lactose intolerance can assimilate sweet dairy products. And this is due to the fact that lactose is broken down not only by lactase, but also by another enzyme - alpha-glucosidase.

So what can not eat with the disease? This should be determined by the attending physician after examination and long-term observation. But if the refusal is inevitable and obligatory, the specialist is also obliged to prescribe a complex vitamin preparation in order to avoid beriberi.

It is worth noting that today there are products with a low content of lactose or even with its complete absence (in them milk sugar is already split into galactose and glucose).

There are some drugs based on lactase, which allow you to use dairy and fermented milk products without any restrictions. This allows you to feel normal and at the same time receive all the necessary and useful components of food.

In addition, therapy may include the use of probiotics, which have pronounced enzymatic and antagonistic properties, but do not have lactose in their composition. They allow to normalize the intestinal microflora and improve its work.

If the product with lactose has been consumed, then symptomatic treatment will allow to eliminate discomfort. Doctors recommend drugs that eliminate spasm of the intestinal walls, as well as reduce the amount of gases. These include "Espumizan", "Smekta".

Let lactose intolerance does not prevent you from living! To do this, follow all the requirements of your doctor.

Lactose intolerance and allergy to milk protein: what is the difference between these two concepts

It is necessary to distinguish between two such concepts as lactose intolerance and milk protein allergy. In the first case, the main cause of the pathological reaction of the body is a deficiency of lactase, the enzyme responsible for the breakdown of lactose in the intestine into simple sugars. It lingers in the gastrointestinal tract and undergoes fermentation, causing swelling, flatulence and, as a result, cramping, abdominal pain.

If you are allergic to milk protein, the conflict of the immune system with milk proteins, which are perceived by it as an alien protein, comes to the fore, which ultimately leads to the development of an allergic reaction and to the corresponding symptoms. In addition to gastroenterological manifestations, there are skin, such as urticaria, eczema, and others, they are often joined by respiratory manifestations from rhinitis to bronchial asthma.

Statistics of lactase deficiency and spread in the world

In some nations, lactase deficiency is significantly pronounced, and with age, this problem increases. For example, among Africans, Chinese, Indians, Mongols, Australian Aborigines, Alaskan Eskimos, the degree of intolerance reaches a hundred. Scientists attribute this to gene mutation in the process of evolution. Regions in which they were massively engaged in animal husbandry, in particular the breeding of animals that give milk, have the lowest percentage of lactose intolerance. Thus, on average, about 70% of the world's population faced lactase enzyme deficiency, but only 15% of Slavs.

Causes of lactose intolerance

The lack of the lactase enzyme can be either congenital or acquired. But there is a third option - transient (transient) intolerance. It is found in premature babies and is caused by the immaturity of the enzyme systems of the body, therefore, with a diet, it passes with time.

Much more complicated is the situation with congenital lactase deficiency. The only solution to this problem is to refuse dairy products containing it. Acquired form occurs when the "breakdown" of the enzyme systems of the digestive tract due to a number of different reasons:

  • transferred intestinal infections
  • acute or chronic pancreatitis with exocrine pancreatic insufficiency.

Often the cause of lactose intolerance in adults lies in the diet itself, from which dairy products are excluded. An important role is played by the state of the immune system.

Signs and symptoms of milk intolerance

Symptomatology is a violation of the gastrointestinal tract. As a result of fermentation in the intestinal lumen occur:

  • bloating
  • increased gas formation,
  • flatulence,
  • stomach ache.

Often these pains become chronic. Frequent liquid stools, nausea and vomiting are inherent in this pathological condition. The clinical picture of lactose intolerance manifests itself after each consumption of dairy products and, as a rule, does not keep itself waiting. Often patients are irritable, restless, inattentive.

Unlike milk protein allergy, lactose intolerance is not accompanied by typical allergic manifestations. To differentiate it is rather necessary with celiac ethnopathy, a condition caused by genetic sensitivity to gluten, contained mainly in cereals. Gluten enteropathy leads to inflammation of the intestinal mucosa and, as a result, to a violation of digestion.

The symptoms of these two fermentopathies are similar, but the symptoms are more pronounced in the latter: when gluten intolerance is due to impaired absorption in the intestine, general weakness develops, impaired performance, weight loss along with severe gastrointestinal symptoms:

  • loose stools,
  • bloating
  • spastic abdominal pain.

Establishing diagnosis

Diagnostics should begin with a consultation of a gastroenterologist, who during the examination and examination of the patient’s complaints will be able to differentiate this pathology with various enzymopathies, chronic pancreatitis, accompanied by exocrine insufficiency, chronic colitis and foodborne toxicity.

In order to make sure that it is the dairy products that cause the reaction, elimination diet. It implies the exclusion of dairy products from the diet for a certain time. If at this time all the symptoms disappear, the diagnosis is clarified. Further, for its final formulation, other types of research are conducted.

The most accurate diagnostic procedure is considered breath test. For the purity of diagnosis, it is recommended to exclude a number of products, in particular dairy products, as well as cigarettes and medicines. The essence of the method consists in determining the hydrogen content in exhaled air, which, by transformation and fermentation, is released after it is provided to the patient for oral administration of a liquid with a high content of lactose. This test is not recommended for younger children.

The next most important test is blood sugar analysis immediately after consuming foods containing lactose. This analysis is performed on an empty stomach, the patient first drinks a liquid containing a moderate amount of milk protein, then the blood sugar level is measured with an interval of 30 minutes. Stable sugar levels indicate lactose intolerance.

The research method, which is common not only among adults, but also children, is stool acidity analysis. Is carried out by determining the level of acid in the feces. The results may indicate a violation of the enzymatic processing of lactose and confirm or refute the diagnosis of intolerance.

Lactose intolerance treatment

The main method of treatment of milk intolerance is the exclusion from the usual diet of dairy products containing lactose. This is fraught with insufficient intake of calcium into the body, because dairy products are rich in nutrients, especially calcium. Therefore, patients with lactase deficiency need to replenish this important trace element.

A significant amount of calcium is contained in such products:

  • almond,
  • broccoli,
  • green turnip
  • cabbage,
  • oranges,
  • tuna,
  • salmon,
  • canned sardines,
  • calcium fortified juices
  • soy products
  • cereals.

The prescription of calcium preparations, such as: vitrum osteomag, calcemin advance, calcium sandoz forte, calcium DZ nicomed, calcium magnesium chelate, rocaltrol, etc., is not excluded.

What is lactose?

Lactose is a carbohydrate found in milk and dairy products, sometimes called milk sugar. For the human body, it is very important and useful.

For example, lactose stimulates the formation of beneficial bifidobacteria, activates the production of vitamins C and B, promotes the absorption of calcium and serves as a source of energy.

Also, this organic matter can be used as a food additive to improve the taste and quality of products such as toffee, marmalade, chocolate and even sausage.

Very often, lactose is used for medicinal purposes, for example, during the production of penicillin, as well as for the manufacture of infant formula. From lactose get a very valuable drug - lactulose, which is used to treat serious intestinal diseases, effective for constipation, dysbiosis and other ailments of the gastrointestinal tract.

However, despite the use of lactose in medicine, some people have its rejection, which causes disruption in the digestion and causes a lot of inconvenience and discomfort.

Why is this happening?

The specifics of the disease

The fact is that for the assimilation of lactose is responsible for such an enzyme as lactase. It takes part in the hydrolysis of the disaccharide of this carbohydrate, so the lack of an enzyme constantly affects the digestion of milk and dairy products.

Lactose, previously not sufficiently split in the body, reaching the large intestine, begins to cause unpleasant pain. It is noteworthy that some people suffering from this type of disease are not able to process dairy products at all, so they do not even touch them. Others who are ill can gradually digest lactose products, therefore periodically use milk and any types of it in small doses.

Lactose intolerance most often occurs in adults than in children. It is noteworthy that it mainly affects Americans, Asians and Africans. Europeans in general suffer from this disease very, very rarely.

What causes lactose intolerance?

Causes of disease

The fact that a person cannot tolerate this type of carbohydrate is often influenced by reasons beyond his control.

For example, with age, the human body begins to produce less and less enzymes to process lactose.

In addition, sometimes hormonal or genetic failure affects this ailment. Sometimes babies are born with congenital lactose intolerance.

Кроме того, на эффективность расщепления молочного сахара могут влиять такие заболевания желудочно-кишечного тракта, как гастроэнтерит, дисбактериоз, язвенный колит, химиотерапия, травмы кишечника и другие.

Как же определить, что у вас или у вашего ребенка непереносимость лактозы?

Тревожные симптомы у детей

Следует помнить, что у каждого индивида лактозная непереносимость проявляется по-разному. However, there are a number of major manifestations of this disease. In total, it is bloating and gas.

How to determine lactose intolerance in infants? Symptoms can be very pronounced and intense.

First of all, watch how the baby feels during breastfeeding. Does he stretch himself to the chest or does he refuse to eat, knowing that it will hurt? Does he fall asleep after feeding or does he spit up milk and cry loudly?

In general, a strong, sudden and repeated crying of a newborn often means that he is worried about colic and abdominal pain. This may be due to lactose intolerance.

You should also pay attention to cal baby. Does it smell sharp sour? Is the stool frequent and frothy, with a lot of mucus?

When examining a sick baby, a distended abdomen is also detected.

Adult Symptoms

How does lactose intolerance manifest in adults? Symptoms of this disease are as follows:

- sharp periodic pain in the abdomen (after consumption of dairy products),

- diarrhea (frequent and watery),

- flatulence (bloating and loud gases),

Effects

Against the background of the symptoms of lactose intolerance described above, other anxious manifestations may also appear. First of all, it is:

- irritability and bad mood.

If a neglected form of milk sugar intolerance is found in a newborn, then it is accompanied by growth and development retardation.

What to do if you find the symptoms listed above in yourself or in your baby?

Treatment of the disease in babies

Treatment of lactose intolerance in children and adults may differ in many ways.

If the disease occurs in a newborn, then, first of all, it is necessary to monitor the nutrition of the nursing mother. With the permission of the pediatrician, she should use drugs with lactase, an enzyme for proper digestion of lactose, which, if it enters the child’s body with milk, will help him break down milk sugar.

To improve the structure of the intestinal microflora, it may be necessary to use drugs such as Linex, Bifidumbacterin and others. Folk remedies can also help here, which should be used with extreme care and caution.

For example, when bloating the tummy and colic, a light decoction of chamomile and weak fennel tea can help, which are recommended to give the baby three times a day, one teaspoonful or 50-70 ml, respectively.

Moreover, herbal decoctions of coriander, fennel, anise and chamomile will help improve the child's digestion. Such weak gulls can be given three or four times a day, ten drops or less.

To eliminate the symptoms, you can also use medicinal preperaty, such as "Smekta", "Espumizan", "Bobotik" and others.

Often it may be necessary to completely abandon breastfeeding and transfer the child to artificial lactose-free feeding. Such an important step should be taken only after consulting with your doctor.

However, we discussed this set of methods for the treatment of lactose intolerance in children. How to be an adult?

Treatment of illness in adults

Often, the treatment itself in adults is manifested only in the complete and categorical rejection of milk and dairy products. And yet, remember that lactose is found not only there. Products containing this carbohydrate include sausages and sausages, spices and instant food sets, pastries and chocolate, gum and vodka, as well as almost all fast food items.

If you are horrified by the above list, do not worry - there are many products without milk sugar! Diet for lactose intolerance includes the use of such beneficial ingredients as:

- vegetables, fruits, berries,

- rice, all cereals, pasta and legumes,

- soybeans, nuts and eggs,

- homemade alcoholic beverages (beer and homemade wine).

However, do not rush to completely switch to milk-free nutrition - listen to your body. Perhaps, in agreement with your well-being, you can occasionally use small amounts of dairy products. In addition, it is worth considering to switch to lactose-free milk and cheeses, which are sold in some supermarkets.

What to remember when dieting

It is imperative to remember that the complete abandonment of dairy products is a huge calcium deficiency that is necessary for bones and the whole body. Therefore, try hard to use foods rich in this trace element.

- greens and sesame,

- sardines in oil and dried fruits,

- shrimps and olives,

Often it may be advisable to take drugs rich in calcium, as well as other minerals - magnesium, sodium and phosphorus.

And what about babies? How to enrich their body with beneficial trace elements in lactose-free diet?

First of all, the baby can enter the feed with the help of broccoli puree and liquid oatmeal. You also need to give your child a drug with vitamin D. It should be remembered here that the main source of this vitamin is, of course, the sun. Therefore, walk with your baby more often and do not be afraid of the gentle morning sun.

As you can see, lactose intolerance is a rather complicated and unpleasant disease. But this does not mean that all your life you will be deprived of the pleasure of eating tasty tasty food. On the contrary, thanks to a corrected diet and a wise approach, you can enjoy even more nutrition and you will feel like a complete, completely healthy person!

Lactose intolerance - the main symptoms:

  • Cramps
  • Abdominal pain
  • Nausea
  • Loss of appetite
  • Bloating
  • Rumbling in the stomach
  • Loose stools
  • Capriciousness
  • Vomiting after eating

Lactose intolerance is a violation of the gastrointestinal tract, which is characterized by complete or partial non-perception of lactose. This pathological process is due to the lack of an enzyme that is responsible for the processing of dairy products - lactase. The first symptoms may occur in adolescence and adulthood. It should be noted that lactose intolerance in infants is extremely rare.

Lactose intolerance may be due to the following etiological factors:

  • genetic predisposition
  • celiac disease
  • acute intestinal infections
  • allergy to gluten and milk proteins,
  • previous gastroenterological pathologies or the presence of such illnesses in a chronic form.

Clinicians note that most often this pathology is caused by genetic predisposition or previously transferred acute gastrointestinal infectious processes. It should be noted that in infants such a violation may be temporary, since the baby’s body cannot yet fully produce lactase.

Prevention

Against this disease there is no specific prevention. However, it is possible to significantly reduce the risk of developing such a pathology if all acute intestinal infections are treated promptly and correctly and eaten properly. Also, do not forget about the systematic passage of a routine examination by medical specialists.

If you think you have Lactose intolerance and the symptoms characteristic of this disease, doctors can help you: a gastroenterologist, a therapist, a pediatrician.

We also suggest using our online disease diagnostics service, which selects possible diseases based on the entered symptoms.

Intestinal dolichosigmoid is an abnormal condition in which the lengthening of the sigmoid colon (the final calving of the large intestine, which ends in the rectum) occurs. In some cases, dolichosigmoid can occur without any unpleasant symptoms throughout a person’s life. In this case, clinicians consider this a variant of the norm and a feature of the body structure. But still, more often, an elongated sigmoid colon gives a person a lot of inconvenience — unpleasant symptoms that complicate life appear. It should be noted that dolichosigma can develop in adults and children. There are also no restrictions regarding gender.

Clostridiosis is an infectious disease that most often occurs in an acute form. The trigger factor for the development of the pathological process is pathogenic clostridium microorganisms that release toxins, which leads to extremely negative consequences.

Rotavirus infection is an infectious disease triggered by rotavirus. Rotavirus, the symptoms of which are manifested in moderate symptoms of enteritis or gastroenteritis, is often combined with respiratory and intestinal syndromes during the initial manifestation of the disease. People of any age are susceptible to rotavirus infection, meanwhile, the incidence among children from six months to two years is most often noted.

Giardiasis is a fairly common disease that develops because of damage to the liver and small intestine. Giardiasis, the symptoms of which provoke such parasites as Giardia, can occur in both mild and severe degree of their own manifestations. It also happens that the carriers of parasites do not get sick, but they freely infect people around them, because in this case their body acts as a fairly convenient and safe container for Giardia.

Opisthorchiasis is a pathological process that causes serious harm to the spleen, liver, pancreas. Factors contributing to the formation of this disease, are in the defeat of the body cat fluke. The course of the disease for a long time is characterized by frequent exacerbations, which can result in pancreatic and liver cancer.

With exercise and temperance, most people can do without medicine.

The occurrence of the disease Lactose intolerance

Lactose intolerance occurs in the absence of lactase - an enzyme that helps digest lactose.

Lactose intolerance is usually transmitted genetically, and its symptoms develop in adolescence and adulthood. Sometimes lactase production is stopped after a short-term illness, such as an upset stomach, or a chronic disease, such as cystic fibrosis, or after surgical removal of a part of the small intestine. Such a problem can be either temporary or permanent.

In rare cases, newborns are lactose intolerant.

In some premature babies, temporary lactose intolerance is also possible, since their organisms cannot yet produce lactase.

Symptoms of the disease Lactose intolerance

The symptoms of lactose intolerance depend on the amount of lactase produced. Symptoms usually begin 30 minutes to 2 hours after dairy products. The main symptoms of lactose intolerance include:

  • Bloating.
  • Pain and cramps.
  • Rumbling in the stomach.
  • Gases.
  • Frequent liquid stools or diarrhea.
  • Vomiting.

If you feel permanent discomfort after a glass of milk, ice cream or other dairy product, this may indicate lactose intolerance. Sometimes symptoms appear or worsen with age. If you assume you are lactose intolerant, consult your doctor.

Treatment of lactose intolerance disease

If you think you are lactose intolerant, consult your doctor. It will eliminate mucous colitis, inflammatory bowel disease and overdose with laxatives. If you are diagnosed with lactose intolerance, then you will be forced to limit the amount of dairy products and milk consumed for the rest of your life. Dairy products contain different amounts of lactose:

Content of lactose and calcium in products

Products with less lactose, such as Swiss cheese or cheddar cheese, may not be a problem. If you are not sure of the amount of lactose in the product, try a small piece of it and wait for the results.

Combine dairy products with other products.. Such combinations (for example, a bread and dairy product) can reduce or eliminate symptoms.

Distribute the consumption of the desired amount of dairy products throughout the day.. Most patients can consume dairy products in small portions throughout the day.

Drink and eat dairy products with reduced lactose content. In most grocery stores you can buy milk with a reduced content of lactose. Some patients confirm that milk helps control symptoms. Others believe that the taste of such products is too sweet or they are too expensive. Patients with diabetes notice an increase in blood sugar levels above the norm when using such products.

Try replacing dairy products with other products.such as soy milk and soy cheese. You can also use artificial coffee cream, but keep in mind that such products do not contain all the necessary vitamins and minerals.

Try products containing lactase. Lactase is a dietary supplement that helps digest lactose.

Eat yogurt with live bacteria (not pasteurized). Studies have shown that such yogurt helps digest lactose. Carefully study the labels on the packaging.

When purchasing products, check their declared components. The "hidden" names of lactose include:

  • Powdered milk.
  • Serum.
  • Cottage cheese.
  • Dairy offal.
  • Skimmed milk powder.

One of the biggest drawbacks of lactose intolerance is the limited amount of nutrients used in dairy products, especially calcium. Calcium is especially important for women, as it strengthens the bones and reduces the risk of osteoporosis. Non-dairy products that contain calcium include:

  • Broccoli, okra, braunkol, kale and green turnip.
  • Canned sardines, tuna, and salmon.
  • Calcium-fortified juices and cereals.
  • Calcium-fortified soy products.
  • Almond.

For calcium absorption, the body needs vitamin D. Vitamin D is found in fortified milk, soy milk, butter, margarine, egg yolks, and liver. If you are not sure that you are getting enough calcium, vitamin D, and other important nutrients found in dairy products such as magnesium, potassium, protein, and riboflavin, consult your doctor. He may recommend supplementation or a visit to a nutritionist.

You should also consult your doctor if symptoms persist despite treatment or worsen. Contact your doctor if you have a fever, chills, severe abdominal pain or vomiting.

What should be remembered

Lactose intolerance is rare in infants with normal birth weight and in infants. If you notice symptoms of lactose intolerance in a child, consult a doctor immediately. Diarrhea is especially dangerous, as it can lead to dehydration, a serious problem that requires immediate attention. Babies who eat breast milk do not develop lactose intolerance, because breast milk contains lactase, an enzyme that helps process lactose.

The composition of lactose

Lactose is disaccharide , that is, consists of two elemental sugars, which are the minimum structural units. Any complex carbohydrate (for example, starch, lactose, or cellulose) breaks down precisely into monosaccharides, which are absorbed into the blood and used by the body for various purposes.

Since lactose consists of two monosaccharides (glucose and galactose), then when it enters the human body under the action of digestive enzymes it is on them that the whole compound disintegrates. As a result of the breakdown of lactose into glucose and galactose, the latter are absorbed into the blood and utilized by the cells of the human body. The enzyme that breaks down lactose into galactose and glucose in the digestive tract is called lactase.

Chemical properties

From a chemical point of view, lactose belongs to the class of reducing carbohydrates, which are capable of releasing electrons with breaking their own oxygen bond. Lactose is characterized by the properties of a weak acid, therefore it is able to react with sodium hydroxide (caustic soda). One mole of lactose can neutralize two moles of sodium hydroxide. In general, lactose is a chemically quite active substance, since its structure contains alcohol functional groups, and the molecule is able to take the form of an aldehyde.

The link between the glucose and galactose molecules in the lactose compound is through oxygen, and is called glycosidic. By participating in chemical reactions, lactose can disintegrate into monosaccharides precisely due to the breaking of the glycosidic bond. The breaking of this glycosidic bond can be carried out by the action of special enzymes (lactase), or by hydrolysis in solutions of strong acids. Most often, sulfuric and hydrochloric acids are used for chemical hydrolysis of lactose, and the rate of this process depends on the temperature. The higher the temperature - the faster the hydrolysis of lactose occurs under the action of acids.

При помещении лактозы в растворы щелочей (например, едкого натра) она распадается до кислот с сохранением сахариновой структуры. Это означает, что щелочи приводят к распаду лактозы на два моносахарида, с образованием у каждого из них активной кислотной группы, превращающей соединение в кислоту. Процесс щелочного гидролиза лактозы зависит от температурного режима.

The enzymatic hydrolysis of lactose is carried out by lactase or beta-galactosidase, which are produced by the microorganisms of the normal intestinal microflora.

In addition to hydrolysis, lactose undergoes a fermentation process, as a result of which a variety of dairy products and cheeses are obtained.

Lactose undergoes a melanoidin reaction, which is also known as the "Maillard reaction." Melanoid reactions consist in the formation of various compounds from sugars, in this case lactose, in combination with peptides, amino acids, etc. These compounds are called melanoids because they have a dark color. The mechanism of these reactions is very complex, proceeds with numerous intermediate stages. As a result of melanoidin reactions, various substances can be formed from lactose (for example, furfural, hydroxymethylfurfural, acetaldehyde, isovalerian aldehyde, etc.), which add flavor and characteristic smell to milk processing products.

Application

Lactose today is used very widely. It is used in the following industries:

  • technological processes of industrial food preparation,
  • preparing microbiological media for growing cell cultures, tissues or bacteria,
  • analytical chemistry,
  • feed vitamins
  • infant formula for artificial feeding,
  • substitutes for women's milk.

Today, the most widespread use of lactose for the manufacture of baby food and various milk substitutes. In the process of baking bread, lactose is used to form a beautiful brown crust on the surface of products. Confectioners use lactose to improve the properties and taste of caramel.

Also, lactose is a necessary component of chocolate, condensed milk, marmalade, jams, biscuit dough, sweets, meat and diabetic products. Usually it is added to products along with regular sugar, and their optimal ratio is 1: 1. Adding lactose to meat products eliminates the bitter taste and reduces the salinity, and also prolongs the shelf life. It is also added to vodka in order to enhance and soften the taste of strong alcoholic beverages.

Adding lactose along with sugar to jams, jams, marmalade and sweets sets off and enhances the taste of the finished product. In addition, it is able to enhance the natural smell, so it is used for the production of various flavor and aromatic additives.

Lactose is a necessary component of lactulose, which is a laxative agent, and is also used to manufacture dietary supplements used to treat and prevent dysbacteriosis.

Biological benefits of lactose

Lactose is a necessary component for the synthesis of various substances that give viscosity to saliva. It also enhances the production of vitamin C and B vitamins. Once in the intestine, lactose promotes absorption and maximum absorption of calcium.

The main property of lactose is that this carbohydrate is a substrate for the reproduction and development of lactobacilli and bifidobacteria. And lactobacilli and bifidobacteria normally form the basis of normal intestinal microflora. That is, lactose is necessary for the prevention and treatment of various dysbacteriosis.

In addition, lactose has a positive effect on the development of the central nervous system in children. In adults, it is a powerful stimulant of the nervous system. Also, lactose is a good preventive measure that prevents the development of cardiovascular diseases.

Products containing lactose

Lactose enters the product in two ways - natural and artificial. In the natural way, lactose is merely a component of the ordinary natural product. And when the artificial way it is added to food in their production, according to the recipe.

So, lactose as a natural component is found in all dairy products, such as:

  • whole or dry milk,
  • whole or dry whey,
  • cheeses
  • sour cream,
  • yogurts,
  • butter,
  • koumiss,
  • cottage cheese, etc.

As a necessary component, lactose is added to the following products during their production:
  • sausages and sausages,
  • ham,
  • jam, jam, jam, marmalade,
  • instant soups,
  • bread and pastry
  • ice cream,
  • breadcrumbs,
  • biscuit dough and products from it (cakes, pastries, etc.),
  • croquettes,
  • industrial sauces (ketchup, mustard, mayonnaise, etc.),
  • nut butter,
  • fast food,
  • flavor enhancers,
  • sweeteners in various semi-finished and finished products,
  • condensed milk,
  • coffee cream
  • loose spices (for example, for potatoes, for fish, for meat, etc.),
  • bouillon cubes,
  • chocolate and chocolate icing,
  • sucking sweets
  • chewing gum,
  • cocoa powder,
  • biologically active additives (BAA),
  • semi-finished products for baking (donuts, puddings, etc.),
  • instant mashed potatoes
  • auxiliary component of some pills.

Lactose-free blends

Virtually every corporation that produces infant formula has a wide range. Many different options are almost always available and lactose-free mixtures are necessary for children who suffer from milk sugar intolerance. In mixtures without lactose, its content is close to zero, that is, there are trace amounts of this substance. So, lactose-free mixtures are available in the following baby food manufacturers:

  • Grandma's basket,
  • Nan
  • Semper,
  • Lemolac,
  • Humana,
  • Nutrilak soy,
  • Nutrilon
  • Bilact
  • Friso,
  • Similac.

Lactose-free mixtures are prescribed for children who do not tolerate mother's milk, which contain this sugar without fail. In such situations, it is often necessary to stop breastfeeding and switch to baby food that does not contain lactose. Unfortunately, lactose-free mixtures have low taste, so the child may refuse to eat them. In this case, only strong hunger will force the baby to accept the proposed food.

Today, lactose intolerance is amenable to therapy, so do not think that the child will have to constantly eat lactose-free mixtures. However, during the period of treatment and preparation of the baby for full feeding it is necessary to use such mixtures for baby food. After six months, the child can receive complementary foods that can replace lactose free mixtures. However, it is better to prepare porridges and mashed potatoes also on the basis of such mixtures without lactose, adding fructose to them to improve the taste.

Against the background of feeding a baby with a lactose-free mixture, a digestive disturbance may develop for some time (for example, colic, flatulence, diarrhea, stool discoloration). If before the child was carrying food normally, and the parents continue to give him the same product, without replacing it with another mixture, then dysbacteriosis may occur. Sometimes a series of mixtures update, and the composition remains the same, but the reaction of the child is completely different. In such a situation it is worth changing the mixture.

Transfer the child to lactose-free mixtures should be phased. Pediatricians usually recommend sticking to the following regimen:
1. On the first day, 30 ml of a lactose-free mixture is administered per feeding along with the usual diet.
2. On the second day, a lactose free mixture is administered for any two feeds of 30 ml each.
3. On the third day, two feedings are completely carried out with a lactose-free mixture.
4. On the fourth day, the child is completely transferred to the lactose free mixture.

Lactose intolerance in newborns, children and adults - a common characteristic

Lactose intolerance can occur in people at any age, but more often it affects adults. This is due to the fact that as they grow older, a person stops feeding exclusively on mother's milk, and lactase is no longer produced in his body in sufficient quantity. As a result, the person ceases to carry milk. Most often, such a physiological intolerance of milk in populations of people of the Caucasian race is formed in children by the age of 9 to 12 years. However, many people retain the ability to produce lactase to a very old age and, accordingly, to transfer milk normally.

Unfortunately, lactose intolerance does not extend only to the ability to absorb whole milk. People suffering from such intolerance to milk sugar, can not eat and cottage cheese, and ice cream, and homemade cheeses.

Sometimes lactose intolerance occurs in newborns or young children, which is also caused by a deficiency of the enzyme lactase. Basically, this enzyme deficiency is due to genetic factors. Thus, the best tolerability of milk, which is preserved in adulthood, is observed in white Europeans, especially in the inhabitants of the north of the mainland (Danes, Dutch, Swedes, Finns, British). Among the representatives of these ethnic groups, lactose intolerance is found only in 1 to 5% of adults. Among the French, Germans, Swiss, Austrians and Italians, people suffering from lactose intolerance are already more: from 10 to 20%. But among carriers of Asian genes (Indians, Chinese, Kazakhs, residents of Southeast Asia), 70–90% of adults suffer from lactose intolerance.

Usually, children of ethnic groups who tolerate lactose well rarely suffer from its deficiency. But children who have the genes of ethnic groups that do not tolerate lactose, may suffer from its intolerance almost from birth. For example, 90% of Chinese begin to suffer from lactose intolerance by the age of 3-4 years. In Russia, the prevalence of milk intolerance varies depending on the region and the genetic characteristics of the resident population.

In children up to six months, functional lactose intolerance is often encountered, which is associated with traumatic damage to the intestine. In this case, injury to the intestinal mucosa can occur under the action of allergens, one of which is milk protein. When allergic to milk protein, 60% of these children have a cross-allergy to soy protein.

Also, trauma to the intestine can occur against the background of gastritis, dysbacteriosis, antibiotic therapy, etc. All these situations lead to a deficiency of lactase, which is simply not produced in the right quantity. In such a situation, it is necessary to continue to feed the child with conventional formula or breast milk, but slightly increasing their fat content. To do this, add a few tablespoons of olive oil to the mixture, and breastfeeding should use the following method: before giving the breast to the baby, strain about a third of the milk so that the baby sucks the last portions of the breast. The fact is that the last 20% of milk is the fattest, and the first 20% is the most fat-free.

The degree of lactose intolerance can vary - from complete to partial, or almost imperceptible. The degree of intolerance is determined by the deficiency of lactase. If a child or an adult has a small lactase deficiency, then he may not suffer from lactose intolerance at all and quite safely use whole milk.

Lactose intolerance should not be confused with milk allergies. These are completely different states of the body. If lactose intolerance to a person who drank milk ends up digestive disorders or poisoning that are not life threatening, then an allergy can also be fatal. If you are allergic to milk, you can not even use the minimum amount of products that contain it.

Lactose deficiency

To describe the state arising in violation of the breakdown of lactose, use two terms:
1. Lactase deficiency.
2. Lactose intolerance.

Lactase deficiency - this term reflects an enzyme deficiency (lactase) that breaks down lactose. And the term "lactose intolerance" reflects the physiological state, resulting from the inability to normally digest and absorb milk sugar. Thus, two terms - "lactase deficiency" and "lactose intolerance", denote the same state, only describing it from different points of view. Since the name of lactose milk sugar "lactose" is very similar to the name of the enzyme that breaks it down "lactase", often people use the term "lactase deficiency" as "lactose deficiency".

Lactose intolerance - causes

As mentioned above, lactose intolerance is due to genetic factors. The more a child of Caucasian genes, the lower the probability of developing lactose intolerance. Accordingly, the more Asian children have in a child, the higher the likelihood of intolerance. Congenital lactose intolerance occurs predominantly in Asians.

There are cases of functional lactose deficiency that are associated with impaired lactase production, regardless of genetic factors. Usually, this phenomenon is a consequence of any process that disrupts the normal functioning of intestinal cells. Thus, a similar phenomenon occurs in people suffering from dysbacteriosis, enteritis, gastritis and other diseases of the gastrointestinal tract. Even viral infections, such as the flu, can injure the intestinal mucosa. As a result, with these pathologies, normal microflora bacteria are not able to produce the required amount of lactase, as a result of which a person develops lactose intolerance. However, after curing the pathology of the digestive tract or eliminating a condition that disrupts the cells of the small intestine, lactase again begins to be produced in sufficient quantity, and lactose intolerance disappears without a trace.

With age, the level of lactase production decreases as a person switches to a mixed diet. The degree of decrease in lactase activity and determine the degree of lactose intolerance in the future. But the speed and degree of decrease in the activity of lactase is largely determined by genetic factors. For example, 90% of Chinese children by the age of 3–4 suffer from lactose intolerance, and in white Europeans it is produced in the same form only by the age of 25.

Small intestine biopsy

So, small intestine biopsy is the most accurate method for diagnosing lactose intolerance. For the analysis, several microscopic pieces of the mucous membrane of the small intestine are taken, on which the activity of the enzyme lactase is determined. If the lactase activity is reduced, then a person has lactose intolerance. This method for the diagnosis of lactose intolerance in children is used very rarely, since it is associated with severe and traumatic sampling for the study (biopsy is taken under general anesthesia).

Lactose curve

Lactose Curve - This method is similar to the glucose curve. To build a curve, you need to take a blood test for lactose in the morning on an empty stomach. Then a person takes a certain amount of lactose, and within an hour blood is taken several times to determine the concentration of milk sugar. Then build a graph of changes in the concentration of lactose in the blood, depending on the time elapsed after its reception.

After constructing the lactose curve, it is compared with the glucose curve, and, based on the relative position of the graph, it is concluded that lactose intolerance is present or not. If the lactose curve passes on the graph below the glucose curve, then there is an insufficient splitting of lactose, that is, lactose intolerance.

The information content and accuracy of the lactose curve is not too high, but this test is more reliable than the common and popular analysis of feces for carbohydrates. But it is very difficult for an infant to build a lactose curve, since it is necessary to give him only an empty stomach lactose, after which several times to draw blood from a finger.

Analysis of feces for carbohydrates

The analysis of feces for carbohydrates is the most common and popular method for the diagnosis of lactose intolerance in children. However, this test is uninformative, since it gives a huge number of false-positive and false-negative results. In addition, the appearance of carbohydrates in the feces and a decrease in its pH depends on a variety of reasons, one of which may be lactose intolerance.

So, firstly, the norms of carbohydrate content in the feces of young children today are absent. There are reference values ​​that have been clarified empirically and taken as options within which the concentration of carbohydrates in the feces of children may vary. For example, today it is the norm that the amount of carbohydrates in the feces should not exceed 0.25%. However, a number of research institutes engaged in the study of this problem, give other values ​​of the age norm:

  • up to 1 month - 1%,
  • 1 - 2 months - 0.8%,
  • 2 - 4 months - 0.6%,
  • 4 - 6 months - 0.45%,
  • older than 6 months - 0.25%.

In addition, this technique allows you to simply determine the presence of carbohydrates in feces. But it can be lactose, and glucose, and galactose, so it is impossible to say that the content of lactose is increased. Thus, this analysis can not accurately confirm the presence of lactose intolerance. Its result can only be considered in conjunction with other analyzes and symptoms present in the child.

Coprogram

Копрограмма позволяет определить кислотность кала, а также выявить, какие вещества содержатся в кале. Для диагностики лактозной непереносимости важное значение имеет кислотность кала и содержание жирных кислот. При непереносимости лактозы реакция стула становится кислой, рН снижается с нормальных 5,5 до 4,0. Также при непереносимости лактозы повышается концентрация жирных кислот в кале.

Аллергия на лактозу

Аллергии на лактозу, как таковой, не существует. Может быть непереносимость лактозы и аллергия на молоко. These two conditions are often confused, but allergies and intolerances are fundamentally different pathologies. Milk allergy is associated with proteins, and lactose intolerance is associated with the presence of sugary carbohydrate.

If you are allergic to milk it can not be used in principle, even a small sip. You should also avoid any products that contain milk powder or whey powder. But with lactose intolerance, milk and dairy products can be consumed, but in limited quantities, since the human condition depends on the activity of lactase and the amount of food eaten with lactose.
Milk protein allergy is manifested by the following symptoms:

  • difficulty breathing
  • feeling of tightness in the throat,
  • nasal mucus secretion
  • eyelid and eye swelling
  • rash on the skin,
  • itchy skin
  • vomiting.

Lactose-free milk

People who suffer from lactose intolerance can drink special milk, which is produced by many leading concerns in this field. On packs with such milk it is indicated - "without lactose". This means that all the lactose of such milk was decomposed into glucose and galactose with the help of the enzyme lactase. The process of splitting lactose was simply carried out under artificial conditions. That is, milk without lactose contains ready-made products - glucose and galactose, into which it normally splits in the human intestine. As a result, a person suffering from lactose intolerance, gets already ready for the absorption of substances - glucose and galactose, which are well absorbed in the intestine.

Where can one buy?
Today, lactose-free milk is sold in large retail chains or specialized stores. Such milk is produced by large concerns, for example, Valio, President, Parmalat, etc. In addition, lactose-free milk can be ordered with delivery through various online stores.

Lactose free protein

Many athletes consume a variety of protein food supplements that are needed to improve muscle growth and the ability to train more intensively. However, many proteins contain lactose, which creates certain difficulties. Indeed, many people in adulthood suffer from lactose intolerance, so they can not use products containing milk sugar. Especially to meet the needs of this category of people were developed and produced proteins without lactose.

Today, the following lactose-free proteins are available in the domestic market of sports nutrition and biological additives:
1. Protein Hydrolysis - Optimum Platinum Hydrowhey,
2. Whey protein isolates:

  • Iso-Sensation - the manufacturer of Ultimate Nutrition - contains a small amount of lactose in combination with the lactase enzyme, which quickly ferments existing milk sugar,
  • ISO-100 - manufacturer of Dymatize,
  • Pure Whey - manufacturer Prolab - protein does not contain lactose,
  • Zero Carb - manufacturer of VPX - protein with fast digestibility,
3. Egg whites:
  • Optimum Gold Standard 100% Egg,
  • Healthy 'N Fit 100% Egg Protein,
  • MRM All Natural Egg White Protein,
4. Soy proteins:
  • Optimum 100% Soy Protein,
  • Universal advanced soy protein,
5. Combined vegetable proteins:
  • Arizona Nutritional Sciences NitroFusion - contains protein isolates from peas, brown rice, artichokes. Also contains BCAA and L-glutamine,
  • Sequel Naturals Vega Sport Performance Protein - contains protein isolates from peas, Inca-inchi seeds, hemp, brown rice and alfalfa. Also contains BCAA, L-glutamine and various digestive enzymes,
  • Sun Warrior Raw Protein - contains proteins from peas, cranberries and hemp seeds.

Lactase baby

Baby lactase is a lactase enzyme that breaks down lactose. Lactase baby tablets are intended for use in children with signs of lactose intolerance. In this case, the lactase enters the intestine with milk, and breaks down milk sugar. Acceptance of lactase baby is the completion of the deficiency of the enzyme lactase. The action of the tablets is similar to the reception of Mezim or Creon with pancreatitis, when there is a deficiency of digestive enzymes produced by the pancreas.

Baby lactase must be given to the baby before each feeding. It is best to give half a capsule 4 to 5 times a day. A large dosage of the enzyme can trigger constipation.

Baby lactase helps lactose absorption by relieving the symptoms of intolerance. That is, the child does not worry after eating, abdominal pain, bloating and increased gas formation disappears.

Lactose tablets

Today, lactose is often used as an auxiliary component in many drugs of tablet form. Lactose is necessary for effective pressing of tablets. Therefore, if a person suffers from lactose intolerance, then he needs to carefully read the composition of the tablets and avoid taking medications containing milk sugar. With the urgent need to take tablets containing lactose, against the background of its intolerance, you should take the enzyme preparation Lactase Baby.

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