Lactase Deficiency

    
What is Lactose intolerance?

Lactose intolerance is a condition in which there is an inability to digest food products containing lactose.


This is a protein that is found predominantly in milk or milk-containing foods. The condition is quite prevalent in the older age population (especially Indian) due to both genetic predilection and decreasing levels of the lactase enzyme. 


Lactase is an enzyme that helps break down lactose into glucose and galactose. In any condition in which there is a decrease in enzyme activity, the condition ensues. 



Common risk factors -

1. Age: - Older age increases the risk (>60 years of age) 

2. Ethnicity: - Common in people of African and Asian descent 

3. Diseases of the small intestine 


Primary lactose intolerance is seen in infants and in the old age group due to a deficiency of lactase 


Secondary lactose intolerance is commonly seen with intestinal infection, celiac disease, and other diseases of the small bowel due to difficulty in absorption. 


Treatment of an underlying disorder is key in alleviating symptoms of secondary lactose intolerance.


Clinical features

  1. Diarrhea 

  2. Nausea and vomiting 

  3. Abdominal discomfort (bloating)  


Management


1. Hydrogen breath test 

2. Upper GI endoscopy to rule out small bowel disorders 

3. Colonoscopy


Treatment 

1. Avoidance of lactose-containing foods


2. Treatment of the underlying secondary condition



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