If you are one of the many people who live with lactose intolerance or have trouble digesting dairy, it can be challenging to know what to eat. Part of learning to live with this condition is to understand what a lactase deficiency is and what steps can be taken to manage it. When planning your diet, it is always best to speak with your physician to ensure you are meeting your daily needs for all vitamins and minerals in a way that will not exacerbate your symptoms.
Lactase Enzyme
Your body needs a variety of enzymes to properly break down the food you eat. In order to digest lactose, or milk sugar, you need enough of the enzyme lactase. If your small intestine does not make enough of this enzyme, you can develop a lactase deficiency and become lactose intolerant, says MedlinePlus. If you have lactose intolerance, within two to three hours after consuming dairy products you will develop symptoms such as abdominal bloating, abdominal cramps, diarrhea, gas or nausea. Infants and children may also experience delayed growth and development.
Causes
The enzyme lactase breaks lactose down into glucose and galactose, which are absorbed into your bloodstream. When you do not make enough lactase, lactose moves unprocessed into the colon, where the normal intestinal bacteria interact with it, causing symptoms. Lactose intolerance is a fairly common condition and can occur with age and a decreased consumption of milk. As you consume less lactose, your body adjusts its production of lactase, reports MayoClinic.com. A lactase deficiency can also occur due to surgery, an injury or an underlying condition such as celiac disease, gastroenteritis or Crohn's disease. In rare cases, babies are born lactose-intolerant.
Diagnosis
Since the symptoms of a lactase deficiency can mimic the symptoms of other illnesses, your history of symptoms alone may not be enough for a proper diagnosis. Your physician can perform a hydrogen breath test in which you drink a a lactose-loaded beverage and then have your breath analyzed for the level of hydrogen present, because undigested lactose produces high levels of hydrogen.
Infants and young children may need a stool acidity test to determine the presence of acid in the stool. Undigested lactose creates glucose, lactic acid and other fatty acids, all of which can be detected in a stool sample.
In some cases, a trial of eliminating dairy products for a couple of weeks to see if symptoms resolve and then adding dairy back in to see if symptoms return, will also help to confirm a diagnosis.
Treatment
Everyone's sensitivity to lactose is different, so treatment depends on the severity of symptoms and the underlying cause. For some people, consuming small amounts of dairy at a time is fine, while for others, even a small amount is intolerable. Along with reducing dairy products known to contain lactose, you may need to be careful with foods that contain whey; caseinates; nougat; milk by-products; dry milk solids and powders and curds.
If your condition is severe, eliminating foods with lactose should resolve your symptoms. If your symptoms are mild, consuming only small amounts at one time or combining dairy products with other foods may help. There are also medications that mimic the action of lactase.
If you are unable to consume any dairy, the Cleveland Clinic recommends consuming soy products, tofu, almonds and foods and beverages fortified with calcium to meet your daily calcium needs.
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