What Does It Mean to Be Lactose Intolerance: Causes, Symptoms, and Testing

What Does It Mean to Be Lactose Intolerant: Causes, Symptoms, and Testing

Lactose intolerance - the inability to digest lactose sugar in milk due to insufficient lactase enzyme, can stem from primary genetic causes affecting over 70% of the world's population

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Hello my village people, it’s Dr. Okenye, your village doctor. Do you notice symptoms of bloating, abdominal pain, nausea, vomiting, and diarrhea after ingesting any milk products? You may be lactose intolerant. Those lactose intolerant don’t make enough of the enzyme lactase that helps digest the sugar in milk.

Today, I want to discuss 4 leading causes of lactase deficiency.

  1. Primary lactase deficiency: This is the most common cause of lactase deficiency, found in over 70% of the world’s population, also called lactase non-persistence. The enzyme levels start declining from infancy, and symptoms begin around adolescence or early adulthood.
  2. Secondary lactase deficiency: this is due to diseases that injure the intestinal mucosa like celiac disease, Crohn’s disease, ulcerative colitis, chemotherapy, antibiotics, and gastroenteritis.
  3. Congenital lactase deficiency: Lactase enzyme is decreased or absent at birth.. This is rare, with only around 40 cases reported worldwide till date.
  4. Developmental lactase deficiency: seen in premature infants born 28-37 weeks of gestation. The premature infants’ intestines are underdeveloped, so they can’t break down lactose, but it will improve with increasing age as the intestine matures.

Also read Okenye’s post on “The Importance of Vitamin C: A Vital Nutrient for Overall Health” and “The Sunshine Vitamin: Why You Need Vitamin D and How to Get It

Wondering if you are lactose intolerant because you have concerning abdominal symptoms after drinking a cup of milk? How can you test for sure that you are lactose intolerant? There are several tests out there you need to be aware of:

  1. Dietary elimination: yes, this is an obvious way to know, duh! Just eliminate lactose-containing foods, and if your symptoms resolve with elimination and return with resumption of these foods, then you are lactose intolerant.
  2. Hydrogen breath test
  3. Stool acidity test
  4. Milk tolerance test
  5. Lactose tolerance test
  6. Small bowel biopsy
  7. New modality called genotyping done in Germany and the Nordic states, but is not yet in use in Nigeria and many other countries at this time.

You all know about the most common lactose-containing food products. Keep in mind that yogurt contains varying amounts of lactose. Greek yogurt has the least, so for those of you lactose intolerant friends, this should be your go-to. There are lactose-free milk products in the in United States & Nigeria. Hollandia for example is the only company in Nigeria with such options, and I heard it tastes pretty good.

Read to learn about “Cure-Alls Herbal Scam: The Perils of Unproven Herbal Remedies“and “Vitamin A: The Unseen Threat to Children’s Health

Disclaimer: The information provided is for educational purposes only and is not a substitute for professional medical advice. Always consult your doctor before starting any new medication or treatment. This publication and aurthors does not endorse or recommend any specific medication and is not liable for any adverse effects from the use of this information. You can learn more about Dr. Okenye.

Emmanuel Okenye

Dr. Emmanuel Okenye, DO is a Clinical Assistant Professor of Internal Medicine at Western University of Health Sciences/College of Osteopathic Medicine of the Pacific. He is ABIM board-certified and practices both outpatient at Evergreen Family Medicine and inpatient at Mercy Medical Center in Roseburg, Oregon.

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