If a child has intolerance to milk food, doctors prescribe an analysis for lactose deficiency. Such a pathology is usually found in children, only 15% of adults have a similar enzyme disorder. Poor digestibility of nutrients from milk is becoming a serious problem for the baby, especially for babies. After all, an adult can refuse to use foods with lactose. For a baby, breast milk and formula are the main food. And intolerance to the product always negatively affects the growth, weight and development of the baby.
What is lactose deficiency?
The composition of milk and dairy products includes a sugar substance of the carbohydrate group. It is called lactose. Another name for this carbohydrate is milk sugar. A special enzyme, lactase, is responsible for its processing in the body. This substance breaks down lactose into its constituent parts.
If a person has a deficiency of the lactase enzyme, then this pathology is called lactose deficiency. In this case, milk sugar enters the intestines unsplit, which leads to diarrhea. Nutrients from foods with lactose are not absorbed.
From a medical point of view, it would be more correct to speak not about "lactose" , but about "lactase" deficiency. After all, it is the deficiency of the enzyme that causes the disturbance. However, the term lactose deficiency is rooted in everyday speech. By this concept is meant a deficiency of lactase.
Symptoms of Insufficiency
An analysis for lactose deficiency is prescribed for a baby with the following symptoms:
- The kid is gaining weight poorly, lags behind in development.
- Frequent regurgitation and colic, increased gas formation.
- Concerned about loose stools of green color with an admixture of foam.
- Sometimes feces become stiff and come out with difficulty.
- There is a persistent iron deficiency in the body.
- Dermatitis-like inflammation can be seen on the skin.
The causes of lactase deficiency can be different. Genetic pathology is very rare when an enzyme defect is congenital. This is the most difficult case. Sometimes such a violation is observed in premature babies. Their enzymatic system did not manage to fully form in the prenatal period. Often lactose deficiency is the result of an allergic reaction to milk or intestinal diseases. In adults, such a violation usually occurs due to age-related changes in the functioning of enzymes.
Sometimes diarrhea after feeding with milk occurs with a normal amount and activity of lactase. This suggests that the child is overfeeding, and he has symptoms similar to lactose deficiency. What tests do I need to pass to distinguish between true lactase deficiency and overeating dairy foods? The following studies are usually prescribed:
- analysis of feces for carbohydrates;
- coprogram with determination of acidity;
- blood test for the lactose curve;
- genetic marker test;
- hydrogen test;
- intestinal biopsy (in very rare cases).
Stool Analysis for Carbohydrates
Analysis of feces for lactose deficiency is the most simple and affordable. But it cannot be said that this is the most informative study. This type of diagnosis is used for infants in combination with other methods.
There is no need to specially prepare for the analysis. A nursing mother should not change her diet before examining the baby. The child should eat as usual, the only way to get reliable results. You need to take and take for analysis about 1 teaspoon of baby feces. Do not collect feces from diapers or diapers. Material is recommended to be delivered to the laboratory within 4 hours. This will provide the most accurate analysis results. It is allowed to store biomaterial in the refrigerator for no more than 10 hours.
The study shows the amount of carbohydrates in the feces, but it does not determine the type of sugar substances. But since the baby feeds only on milk, it is assumed that lactose or its cleavage products are released with feces. However, it is impossible to understand which carbohydrate norm is exceeded. In addition to lactose, galactose or glucose can be excreted during milk feeding with feces.
The interpretation of the analysis for lactose deficiency is as follows:
- The norm of carbohydrates is from 0.25% to 0.5%.
- In infants up to 1 month, reference values from 0.25% to 1% are allowed.
Coprogram
A more informative method is a coprogram. Pay attention to indicators such as acidity (pH) and the amount of fatty acids. This is a simple and safe analysis for lactose deficiency in infants. The collection rules are the same as for the carbohydrate test, but the material must be taken to the laboratory immediately. Otherwise, due to the work of microbes, acidity will change.
Such an analysis of lactose deficiency is based on the fact that with a deficiency of the lactase enzyme, the intestinal environment becomes more acidic. This is due to the fact that undigested lactase begins to ferment, and acid is released.
The normal pH value of feces is 5.5. Deviation from this indicator to a smaller side indicates the presence of lactose deficiency. In this case, the amount of fatty acids must be taken into account. The more of them, the higher the likelihood of illness.
If the baby has signs of lactose deficiency, which test is better - a carbohydrate test or a coprogram? This question is often of interest to parents. We can say that the level of acidity is more informative. But it is useful to pass both types of fecal analysis, then one examination will complement the other.
Blood test for the lactose curve
The child is given an empty stomach to drink some milk. Then three times in an hour blood is taken for analysis. This helps to trace the process of processing lactose in the body.
Based on the results, a special lactose curve is built. It is compared with average glucose scores. If the lactose curve is located below the glycemic curve, then this may indicate a deficiency of the lactase enzyme.
This lactose deficiency test is not always well tolerated by infants. After all, if the child actually has such a violation, then after taking milk on an empty stomach, stomach pain and diarrhea can occur. However, this examination is more informative than the analysis of feces for carbohydrates.
Hydrogen test
In the air exhaled by the child, the amount of hydrogen is determined. With lactose deficiency in the intestine, fermentation processes occur. As a result, hydrogen is formed, which penetrates the bloodstream and then exits through the respiratory system.
The child exhales into the measuring device. The concentration of hydrogen and other gases in the air leaving the lungs is recorded. This is a baseline. The patient is then given milk or a lactose solution. After that, repeated measurements of hydrogen are made, and the results are compared.
Normally, the deviation from the baseline after the test with lactose should not be more than 0.002%. Exceeding this number may indicate lactose deficiency.
Such a test is rarely performed with infants, it is usually used for older children and adults. The disadvantage of the test is a possible deterioration in well-being, if the child really suffers from lactose deficiency.
Genetic test
Genetic analysis for lactose deficiency helps to identify this disorder if it is congenital. This study is on a special marker C13910T.
Blood is taken from a vein for analysis. The study takes place on an empty stomach or 3 hours after a meal. Three options for analysis results are possible:
- C / C - this means that the child has a genetic lactose deficiency.
- C / T - this result indicates the patient’s tendency to develop secondary lactase deficiency.
- T / T - this means that a person has normal lactose tolerance.
Intestinal biopsy
This is a very reliable, but traumatic research method. It is extremely rarely used in infants. Under anesthesia, a probe is inserted into the small intestine through the mouth of the child. Under endoscopic control, the mucosa pieces are nipped off and taken for histological examination.
In itself, a slight trauma to the mucosa is not dangerous, since the epithelium is quickly restored. But anesthesia and the introduction of an endoscope can lead to complications. Therefore, when examining young children, this method is resorted to only in the most extreme cases.
Lactose deficiency in adults
In adults, lactose intolerance is either congenital or due to gastrointestinal diseases and age-related changes. The disease manifests itself in gastrointestinal disorders after consuming dairy products. As a result, a person avoids consuming food containing lactose. Because of this, his body lacks calcium, which negatively affects the condition of the bones.
In addition to the above diagnostic methods, there is another analysis for lactose deficiency in adults. The patient is given 500 ml of milk to drink, and then a blood test for sugar is taken. If the glucose level becomes less than 9 mg / dl, then this indicates a violation of the absorption of lactose.
What to do in case of deviation from the norm in the analyzes?
An incurable pathology is only genetically determined lactose intolerance. In this case, lifelong diet and replacement therapy with lactase drugs are necessary. If lactose deficiency arose due to the prematurity of the child, then after some time the enzyme system still begins to develop, and the body is filled with lactase.
In all cases, a diet with a restriction of dairy products is necessary. In some situations, lactose-free and low-lactose mixtures are used for feeding infants, as well as products in soy milk.
In the treatment of lactase deficiency, the following drugs are used:
- lactase enzyme substituents;
- prebiotics;
- medicines for diarrhea and flatulence;
- antispasmodics for abdominal pain.
Adults are shown the use of calcium preparations, so because of the forced rejection of dairy products, they have an increased risk of developing osteoporosis. In most cases, lactose deficiency has a favorable prognosis.