More than half of all adults cannot consume dairy products with impunity. Such an unpleasant surprise for a person who still drank fresh milk freely some time ago is not a pathology, but an absolute norm. It's all about lactase deficiency (in adults, it usually occurs in 7 out of 10 cases), that is, in the body losing its ability to completely process milk sugar. At the same time, this pathology is expressed in different ways and the consequences are most unexpected.
The mechanism of lactase deficiency
The substance of lactose, and otherwise - milk sugar, which gives fresh dairy products their peculiar sweetish taste, is indispensable in the process of the child's proper development. However, before it begins to exert its positive impact, it is required to split it into simpler components, each of which is quite independent. The separation of the element into glucose and galactose occurs in the gastrointestinal tract under the influence of a special enzyme - lactase.
It is fully produced in the human intestinal environment. In a smaller part - by enterocytes, tissues of the intestinal mucosa, and to a greater extent - by bacteria responsible for the normalization of microflora. All its functionality is inherent in the continuous separation of lactic acid into monosaccharides:
- glucose, with the help of which there is an improvement in the digestion and assimilation of micro and macro elements in the body of the baby, as well as the correct intestinal algorithm;
- galactose, without which the formation of the central nervous system and the strengthening of the retina of the eye can not do .
For a baby, the incomplete digestion of lactose is the norm. However, its accumulation to excess volumes will directly speak of an enzyme deficiency, in connection with which doctors diagnose lactase deficiency. How does the same pathology manifest in adults?
Adult Lactase Disease
Starting from the age of three, the intensity of the enzyme's activity decreases, since most of it remains unclaimed. Acquired diseases can also be the cause of lactase deficiency in adults, which will indicate its secondary form. This problem can hardly be called insoluble, because the whole treatment consists in a simple rejection of dairy products.
It is much more difficult if in the etiology of enzyme deficiency lies a disease that needs to be detected and treated. Then lactase deficiency in an adult serves as a signal to which attention must be paid, especially if it manifests itself suddenly.
Disease classification
The enzyme that breaks down lactose may be completely absent in the human body - and then they talk about primary failure, which is quite rare, due to its genetic origin. Such a pathology occurs with the outwardly normal functionality of intestinal enterocytes, which is accompanied by their complete inability to produce lactase. Other variants of lactase deficiency in adults and children, as a rule, are a process of disturbance or decrease in the activity of an existing enzyme:
- the functional form occurs in the case of a sufficient amount of lactase with the inability of the body to completely process it;
- secondary lactase deficiency in adults occurs after the identification and elimination of the current disease, leading to the destruction or depersonalization of the enzyme;
- the transient form occurs in premature babies who do not have time to go through the activation of lactase, which forms at the last stage of pregnancy.
Most often, doctors in their practice encounter secondary lactase deficiency. In adults, it occurs several times more often than in children. And if in the latter the normal digestibility of milk sugar, as a rule, is restored after the treatment, then adult patients risk leaving behind a weak lactose tolerance even after the therapy.
Causes of secondary lactase deficiency
The nature of the primary form of the disease lies in heredity - in a person who undertakes to study the origin of his own milk intolerance, formed in the prenatal period, there will always be a blood relative suffering from this pathology. However, this aspect is so unique that gene transfer is almost never confirmed.
Another thing is secondary enzyme deficiency. Its formation is preceded by a clear deterioration of the gastrointestinal tract as a result of a transferred (current) disease or reaction to any external factor. Possible causes of lactase deficiency in adults are:
- prematurity;
- diseases of the large or small intestine associated with viral infection or the presence of bacterial colonies;
- a consequence of abdominal surgery performed with involvement (reduction) of the intestine;
- celiac disease;
- Crohn's disease;
- overdose or rejection by the body of certain drugs.
The doctor will be able to accurately determine the origin of the pathology only after diagnosis. Lactase deficiency in adults often disappears after deleting a dairy product from the diet, so if no other human health problems bother you, it’s enough to eliminate the intolerable element and do without taking tests.
How to recognize a disease?
It is not difficult to conduct a self-diagnosis of a suddenly worsened state of health, especially if, shortly before the appearance of alarming signs, a person used lactose-containing substances. Symptoms of lactase deficiency in adults will immediately attract attention:
- nausea, less often - vomiting with an abundance of separated masses;
- flatulence, flatulence;
- severe diarrhea, accompanied by pain in the stomach and intestines;
- the appearance of spots on the skin, a rash;
- heartburn, sour belching;
- dizziness, weakness.
As a rule, symptoms of lactase deficiency in adults appear no later than two hours after drinking milk. A characteristic progressive or paroxysmal condition occurs with an intensity proportional to the amount of the forbidden product drunk, as well as the severity and form of the disease. Sometimes signs of lactase deficiency in adult patients with a small amount of milk consumed may not occur or manifest themselves to a small extent.
In other cases, impaired well-being can be difficult to associate with the presence of lactose and can even be confused with toxic poisoning or cardiovascular problems. A person feels increased hyperhidrosis, increased heart rate and difficulty breathing. Sometimes, against the background of sharply surging symptoms, loss of consciousness occurs.
Primary Diagnostic Methods
Gathering symptoms and making an anamnesis is the first step in establishing a diagnosis, followed by initial testing with a restrictive diet. With the help of a doctor, a special diet is prepared that completely eliminates the presence of lactose, and a period is established during which control will be exercised. In parallel, a laboratory study of feces is being conducted to assess the presence of carbohydrates, which, as you know, form the basis of various sugars.
When it comes to the diagnosis and treatment of lactase deficiency in adults, you need to understand which doctor should be consulted in the first place, namely, a gastroenterologist. Already in the direction from him, it may be necessary to consult an endocrinologist and other narrow specialists, whose task will be to analyze the changes that have occurred in the body during the disease.
Lactase deficiency tests
In Russia, the definition of lactase deficiency in both adults and children does not stand at such a level that at least one analysis gives an unambiguous answer to the presence of the disease and the degree of pathology. The most accessible, and therefore more often prescribed analysis was and remains a stool sampling and studying it for carbohydrate content.
It is believed that normally after the use of milk sugar in the feces should not be present more than 0.25% carbohydrates. However, there is separate information for children of different ages, showing other figures. In addition, in the table of values for adults there is no indication of which groups of carbohydrates should be considered, and which are considered insignificant and are not included in the total percentage. For this reason, the analysis is given the role of one of the supporting studies, but often it also stands for the only one.
Another method gives a greater percentage of the probability of determining the diagnosis and contributes to a more accurate prescription of treatment for lactase deficiency in adults and children - this is a biopsy technique, that is, taking a sample of tissue of the small intestine. It is invasive and has a significant trauma, therefore it is prescribed infrequently and especially rarely for children, as it includes the use of anesthesia in the process.
The next study, the lactose curve, is controversial, since it involves taking a dose of milk sugar on an empty stomach, followed by tracking changes in blood glucose levels. With a strong reaction to lactose, the analysis becomes dangerous, but it is considered several times more reliable than the study of feces, which sometimes justifies the risks.
A sample for the amount of hydrogen in the exhaled air mass is considered the most expensive and therefore not always justified solution. The patient is given milk sugar, and then, at regular intervals, the data obtained from the exhaled air to the sensors of the device is monitored.
Treatment
Before starting active treatment of lactose deficiency in adults, gastroenterologists recommend restoring the intestinal microflora, which has suffered from disorders caused by the use of a prohibited product. To replenish a healthy bacterial environment that maintains the optimal acidity of the body, appoint:
- "Bifidumbacterin" is a probiotic with a bacterial medium already grown and ready for action, which must be taken in several long courses;
- “Bifidum Bag” - a probiotic in concentrated, liquid form;
- Acipol - 10 million live bacteria in each capsule, quickly building up damaged intestinal tissue.
How to treat lactase deficiency in adults, if symptoms appear only after consuming lactose? In this case, special diet food is prescribed. However, a deficiency in a strong form, accompanied by seizures, even in the absence of provocateurs in the diet, is eliminated only with medications. The use of drugs is necessary in all cases of the secondary form of the disease, when the problem is provoked by intestinal inflammation.
Diet for adults
With a mild to moderate degree of the disease, which is well defined by the body's response to the consequences of taking lactose, it is not necessary to completely remove dairy products from the diet. Milk and its derivatives contain a large number of microelements, which are very difficult to replace. Often, missing components can only be filled with special additives. Therefore, you should first try the lightweight version of the diet, built according to the following scheme:
- replacing cow's milk with goat milk;
- the estimated one-time intake of milk sugar (for example, a glass of whole milk) is divided into 3-4 servings of several sips;
- periodically add a teaspoon of good cream to tea or coffee, completely replacing the use of fresh dairy products;
- regular use of kefir or yogurt without flavoring.
With a strong degree of lactose intolerance, the above measures of a restrictive diet are irrelevant - it will have to be excluded completely and in any form.
Prognosis for lactase deficiency
With the rejection of therapeutic measures and unwillingness to follow a diet, the development of dysbiosis is inevitable. In adulthood, this problem also causes complications in the form of stable indigestion, constant belching and periodically recurring attacks of pain.
In childhood (infancy), when parents ignore this disease, serious consequences arise, for example, speech is slowed down, physical development does not keep up with age, and late thinking is found.
Is there a chance to step over pathology and return to the usual diet? In the secondary form of the disorder, the resumption of a normal lifestyle is possible almost immediately after the cure of the underlying disease, in which lactase deficiency existed as a concomitant symptomatology. When the body begins to respond positively to treatment and noticeable changes in the reverse dynamics of the pathology are felt, you can try to introduce fermented milk products into the diet in small portions. You need to increase the amount of lactose gradually and with constant monitoring of your own well-being.
Holders of genetic rejection of milk are forced to limit themselves in milk sugar all their lives. There are no drugs that block the effects of lactose on the body, so a tough, dairy-free diet remains the only option for maintaining good health.