Lactose Tolerance Tests-causes and symptoms of lactose tolerance
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What is a Lactose Intolerance? Tests, Types, Causes and Symptoms of Lactose Intolerance

Are you or your loved ones suffering from any of these symptoms quite often- abdominal pain, flatulence, diarrhea, or vomiting? Well, if the answer is ‘Yes’, then in all probabilities it may be a case of lactose intolerance.

Milk and other dairy products contain a sugar or carbohydrate called lactose. In the normal process, the body breaks down lactose into its simpler components with the help of an enzyme called lactase.Unlike other mammals, human beings produce lactase throughout their life. Lactose intolerance occurs when the body of an individual becomes incapable of digesting lactose – natural sugar found  in milk.

What is Lactose Intolerance?

Some people have levels of lactase that are lower than normal. For these people, instead of breaking down the lactose in the milk, the lactose will remain in the intestines and ferment. This inability to digest lactose is referred to as lactose intolerance.Without enough lactase, a person can have digestive and other problems when they consume foods containing lactose. This is known as lactose intolerance or lactase deficiency.

This disorder can lead to various symptoms like stomach pain, flatulence and bloating. There is no definite medicine to cure the disorder, but the solution to this problem is by avoiding or limiting the intake of dairy products.

Lactose Intolerance in Babies

A few babies are born without any lactase enzymes at all, and lactose-free formulas may be an option in such cases. However, lactose intolerance does not cause vomiting in babies.

Causes of Lactose Intolerance

Lactose intolerance is mostly genetically determined.

Some of the Causes of Lactose Intolerance are:

  • Congenital –the main cause, where for genetic reasons less lactase than usual is produced
  • Gastroenteritis – this can strip the intestines of lactase for a considerable period of time
  • Parasitic infection – this can temporarily reduce the lactase levels
  • Iron deficiency – lack of iron in the diet can interfere with lactose digestion and absorption.

How is Lactose Intolerance Detected?

Lactose intolerance is detected by means of a test that measures how well your body can process lactose -the sugar found in dairy products.  Normally, the body, is able to process milk and other dairy products due to the presence of an enzyme in the intestines called lactase, which breaks lactose down during digestion.

A lactose intolerance test is a test that measures how well your body can process lactose. The test measures the ability of your intestines to break down a type of sugar found in milk and other dairy products called lactose. If your body cannot break down this sugar you are said to have lactose intolerance.

Types of Lactose Intolerance Tests

There are three kinds of tests that can be used to check lactose tolerance tests:

  • Hydrogen breath test
  • Lactose intolerance test
  • Stool acidity test

1. Hydrogen Breath Test

This is a very common test. During this test, you will be instructed to drink a liquid solution containing lactose, and will then you have you breathe into a balloon-like instrument at set intervals to determine how much hydrogen is there in your breath. If you exhale more hydrogen, it is likely that your body is unable to process lactose. The breath test is considered normal if the increase in hydrogen is less than 12 parts per million over your fasting level.

2. Lactose Intolerance Test

This test is similar to the Hydrogen Breath Test, where you will be required to drink a liquid with lactose. After two hours, your blood sample will be drawn to measure the quantity of glucose in your blood.If your blood glucose level does not rise, it is an indication that your body is not digesting or absorbing lactose. The blood test is considered normal if your glucose level rises more than 30 mg/dL within 2 hours of drinking the lactose solution.

3. Stool Acidity Test

This test is usually done on infants or small children, as other tests cannot be done on them. A stool sample is taken to see if their system is breaking down the lactose properly. Fermenting lactose in the intestines creates lactic acid, which can be detected in the stool.

4. Biopsy of the Small Intestine

Biopsy of the small intestine is an invasive test that is sometimes done for the evaluation of lactose intolerance. The biopsy is usually performed by endoscopy, where a long tube is passed from the mouth into the small intestine. Samples of the lining of the intestinal wall are taken and analyzed for lactose activity. But, the results may not be very reliable because the biopsied area of the intestine may have normal lactose activity compared to other areas of lactose deficiency.

Symptoms of Lactose Intolerance

  • Abdominal pain
  • Bloating of the abdomen
  • Flatulence
  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal cramps

Treatment for Lactose Intolerance

There is no cure for lactose intolerance, but most people are able to control their symptoms by making changes to their diet.Some cases of lactose intolerance, such as those caused by gastroenteritis, are only temporary and will improve within a few days or weeks. Other cases, such as those caused by genetic factors or a long-term underlying condition, can be lifelong.

Though there is no cure for lactose intolerance, various options are available to help you safely consume milk products. Dietary supplements containing lactase may help you digest lactose if you take the tablets immediately after consuming dairy products.

Tips for Managing Lactose Intolerance

  • Don’t give up milk products completely as they are an important source of nourishment. Most people with this condition can tolerate 240 ml of milk per day. A glass of milk contains 8-10 grams of lactose.
  • Drink full-fat milk because the fats slow the passage of the milk through the intestines and allows the lactase enzymes more time to break down the sugars. Soya milk is a good substitute.
  • Avoid low-fat or non-fat milks – they travel quickly through the gut and tend to cause symptoms in lactose intolerant people. Many low-fat milk products may contain skim milk powder, which provides a higher dose of lactose.
  • Some varieties of cheese such as cheddar, Swiss, and mozzarella contain no lactose and can easily be tolerated by people with lactose intolerance.
  • Butter and cream contain very low levels of lactose and are well tolerated.
  • In the same way, yoghurt is also easily tolerated.
  • Remember to always eat foods that contain lactose in combination with other foods. You can also spread them out over the day, rather than eating a large amount at once.
Medically Reviewed By
Dr. Bharti Talreja (MBBS, DPM, FAGE, MIPS)She is a Psychiatrist practising in Indore, India.