If a child has a lactose intolerance, doctors prescribe a lactose deficiency test. This pathology usually occurs in children, only 15% of adults have a similar enzyme disorder. Poor digestibility of nutrients from milk becomes a serious problem for the child, especially for infants. After all, an adult can refuse to use products with lactose. For an infant, mother's milk and formulas are the main food. And intolerance to the product always negatively affects the growth, weight and development of the baby.
What is lactose intolerance?
Milk and dairy products contain the sugary substance of the carbohydrate group. It's 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 intocomponent parts.
If a person has a deficiency of the enzyme lactase, then this pathology is called lactose deficiency. In this case, milk sugar enters the intestines undigested, 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 of "lactose", but of "lactase" deficiency. After all, it is the deficiency of the enzyme that causes violations. However, the term "lactose deficiency" has taken root in everyday speech. This term refers to lactase deficiency.
Deficiency symptoms
A lactose intolerance test is given to an infant with the following symptoms:
- Baby gains weight poorly, lags behind in development.
- Frequent regurgitation and colic, increased gas production.
- Worried about loose green stools mixed with foam.
- Sometimes stool becomes hard and difficult to pass.
- There is a persistent iron deficiency in the body.
- Inflammation similar to dermatitis can be seen on the skin.
The causes of lactase deficiency can be different. A very rare genetic pathology occurs when the enzyme defect is congenital. This is the most difficult case. Sometimes this disorder is observed in premature babies. Their enzymatic system did not have time to fully form in the prenatal period. Often lactose intolerance is the result of an allergic reaction to milk.or bowel disease. In adults, such a violation usually occurs due to age-related changes in the functioning of enzymes.
Sometimes diarrhea after breastfeeding occurs when the amount and activity of lactase is normal. This suggests that the child is being overfed and is developing symptoms similar to lactose intolerance. What tests should be taken to distinguish a true lactase deficiency from an overeating of dairy foods? The following studies are usually prescribed:
- analysis of feces for carbohydrates;
- coprogram with acidity determination;
- blood test for lactose curve;
- genetic marker test;
- hydrogen test;
- Intestinal biopsy (very rare).
Fecal analysis for carbohydrates
The 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 breastfeeding mother should not change her diet before examining her baby. The child should eat as usual, the only way to get reliable results. It is necessary to take and take for analysis about 1 teaspoon of the baby's feces. Do not collect feces from diapers or diapers. The 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 the biomaterial in the refrigerator for no more than 10 hours.
The study shows the amount of carbohydrates in feces, but does not determine the type of sugary substances. But since the baby eats only milk, it is assumed that lactose or its breakdown products come out with feces. However, it is impossible to understand which particular carbohydrate is exceeded. In addition to lactose, galactose or glucose may be excreted in the faeces from milk nutrition.
The decoding of the analysis for lactose deficiency is as follows:
- Normal carbohydrates 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. It is necessary to pay attention to indicators such as acidity (pH) and the amount of fatty acids. This is a simple and safe test for lactose deficiency in infants. The collection rules are the same as in the study for carbohydrates, but the material must be taken to the laboratory immediately. Otherwise, due to the work of microbes, the acidity will change.
This analysis for 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 acids are released.
The normal pH value of feces is 5.5. A downward deviation from this indicator indicates the presence of lactose deficiency. In this case, the amount of fatty acids must also be taken into account. The more of them, the higher the likelihood of the disease.
If the baby has signs of lactose deficiency, which test is better to pass - a study on carbohydrates or a coprogram? This question is often asked by parents. We can say that the level of acidity is more informative. But it is useful to have both types of fecal analysis, then one examination will complement the other.
Lactose curve blood test
The child on an empty stomach is given some milk to drink. Then three times within an hour take blood for analysis. This helps to trace the process of processing lactose in the body.
A special lactose curve is built on the basis of the results. It is compared with the average results of the glucose chart. If the lactose curve is below the glycemic curve, then this may indicate a deficiency of the lactase enzyme.
This test for lactose intolerance 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, abdominal pain and diarrhea may occur. However, this examination is more informative than the analysis of feces for carbohydrates.
Hydrogen test
In the air exhaled by a child, the amount of hydrogen is determined. With lactose deficiency, fermentation processes take place in the intestines. As a result, hydrogen is formed, which enters the bloodstream and then exits through the respiratory system.
Child exhales into the measuring device. The concentration of hydrogen and other gases in the air leaving the lungs is recorded. This is the baseline. The patient is then given milk orlactose 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.
This test is rarely done on infants, it is usually used on older children and adults. The disadvantage of the test is the possible deterioration of 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 is a study 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 eating. There are three possible analysis results:
- С/С - 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 the person has normal lactose tolerance.
Intestinal biopsy
This is a very reliable, but traumatic research method. It is rarely used in infants. Under anesthesia, a probe is inserted through the child's mouth into the small intestine. Under endoscopic control, pieces of the mucosa are pinched off and taken for histological examination.
On her owna 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 caused by diseases of the gastrointestinal tract and age-related changes. The disease manifests itself in gastrointestinal disorders after the consumption of dairy products. As a result, a person avoids eating foods containing lactose. Because of this, his body receives less calcium, which negatively affects the condition of the bones.
In addition to the diagnostic methods listed above, there is another test for lactose deficiency in adults. The patient is given to drink 500 ml of milk, and then a blood test for sugar is taken. If the glucose level falls below 9 mg/dl, then this indicates lactose malabsorption.
What to do if there is a deviation from the norm in the analyzes?
Incurable pathology is only genetically determined lactose intolerance. In this case, lifelong dieting and lactase replacement therapy are necessary. If lactose deficiency arose due to the prematurity of the child, then after a while the enzyme system still begins to develop, and the body is filled with lactase.
In all cases, a dairy-restricted diet is required. In some situationslactose-free and low-lactose mixtures, as well as products based on soy milk, are used for feeding babies.
The following drugs are used in the treatment of lactase deficiency:
- substitutes for the lactase enzyme;
- prebiotics;
- drugs for diarrhea and flatulence;
- antispasmodics for abdominal pain.
Adults are shown the use of calcium supplements, because due to the forced rejection of dairy products, they have an increased risk of developing osteoporosis. In most cases, lactose intolerance has a favorable prognosis.
