More than half of all adults cannot consume dairy products with impunity. Such an unpleasant surprise for a person who drank fresh milk freely some time ago turns out to be not a pathology, but an absolute norm. It's all about lactase deficiency (in adults, it occurs, as a rule, in 7 cases out of 10), that is, the loss of the body's ability to completely process milk sugar. At the same time, this pathology is expressed in different ways and has the most unexpected consequences.
Mechanism of lactase deficiency
The substance lactose, otherwise milk sugar, which gives fresh dairy products their peculiar sweetish taste, is indispensable in the process of proper development of the child. However, before it begins to have its positive impact, it needs to be split 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. To a lesser extent - enterocytes, tissues of the intestinal mucosa, and to a greater extent - bacteria responsible for the normalization of microflora. All its functionality lies in the constant separation of lactic acid into monosaccharides:
- glucose, with the help of which the digestion and absorption of micro- and macroelements in the baby's body is improved, and the correct algorithm of the intestines is built;
- galactose, without which the formation of the central nervous system and the strengthening of the retina of the eye are indispensable.
It is normal for an infant to not fully digest lactose. However, its accumulation to excess volumes will directly indicate a lack of the enzyme, in connection with which doctors diagnose lactase deficiency. How does the same pathology manifest itself in adults?
Lactase disease in adults
Starting from the age of three, the intensity of the enzyme's work declines, since most of it remains unclaimed. The cause of lactase deficiency in adults can also be acquired diseases, 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 the etiology of the lack of an enzyme is a disease that needs to be detected and cured. Then lactase deficiency in an adult serves as a signal to whichattention should be paid, especially if it appeared suddenly.
Disease classification
The enzyme that breaks down lactose may be completely absent in the human body - and then they talk about primary deficiency, which is quite rare, due to its genetic origin. Such a pathology occurs when 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 are usually the process of disrupting or decreasing the activity of an existing enzyme:
- functional form occurs in the case of a sufficient amount of lactase when the body is unable to process it completely;
- Secondary lactase deficiency in adults resolves 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 have not had time to go through the activation of lactase, which is formed in the last term of pregnancy.
Most often, doctors in their practice are faced with secondary lactase deficiency. It occurs several times more often in adults than in children. And if 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 treatment.
Reasons for secondarylactase deficiency
The nature of the primary form of the disease lies in heredity - a person who undertook to study the origin of his own intolerance to milk, formed in the prenatal period, will always find a blood relative suffering from this pathology. However, this aspect is so isolated that gene transmission is almost never confirmed.
Another thing is secondary enzyme deficiency. Its formation is preceded by a clear deterioration in the functioning of the gastrointestinal tract as a result of a past (current) disease or a reaction to some 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;
- as a consequence of abdominal surgery involving (cutting) the intestine;
- celiac disease;
- Crohn's disease;
- Overdose or rejection of certain medicines by the body.
The doctor will be able to accurately determine the origin of the pathology only after diagnosis. Lactase deficiency in adults often resolves after deleting a dairy product from the diet, so if no other he alth problems bother a person, it is enough to simply eliminate the intolerable element and do without testing.
How to recognize the disease?
Self-diagnosis of a suddenly deterioratingwell-being, especially if, shortly before the onset of alarming signs, a person used lactose-containing substances, it is not difficult to carry out. Symptoms of lactase deficiency in adults will immediately attract attention:
- nausea, less often - vomiting with an abundance of separated masses;
- gas formation, flatulence;
- severe diarrhea accompanied by pain in the stomach and intestines;
- skin spots, rashes;
- 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 growing or paroxysmal state 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 appear to a mild degree.
In other cases, the onset of feeling unwell can be difficult to attribute to the presence of lactose and can even be confused with toxic effects or cardiovascular problems. A person feels increased hyperhidrosis, increased heart rate and difficulty breathing. Sometimes, against the background of a sharp surging of symptoms, loss of consciousness occurs.
Primary diagnostic methods
Symptomology and history taking is the first step in establishing a diagnosis, followed by initial restrictive diet testing. With the help of a doctor, a speciala diet that completely excludes the presence of lactose, and a period is established during which control will be carried out. In parallel, a laboratory study of feces is being carried out to assess the presence of carbohydrates there, 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 you need to contact first of all, namely, a gastroenterologist. Already in the direction from him, you may need 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.
Testing for lactase deficiency
In Russia, the definition of lactase deficiency in both adults and children is not 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 the collection of feces and the study of its carbohydrate content.
It is supposed to be considered that normally after the use of milk sugar in the stool should not be present more than 0.25% of carbohydrates. However, there is separate information for children of different ages, showing different numbers. In addition, there is no indication in the table of values \u200b\u200bfor adults which groups of carbohydrates should be taken into account, and which are considered insignificant and are not included in the total percentage. For this reason, analysis plays a roleone of the confirmatory studies, but often it also advocates 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 tissue sample 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, as 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 test becomes dangerous, but is considered several times more reliable than a stool test, which sometimes justifies the risks.
The test 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 is monitored on the sensors of the device.
Treatment
Before starting active treatment of lactose deficiency in adults, gastroenterologists recommend restoring the intestinal microflora affected by disorders caused by the use of a forbidden product. To replenish a he althy bacterial environment that maintains optimal body acidity, prescribe:
- "Bifidumbacterin" - a probiotic with a bacterial environment already grown and ready for action, which must be taken in several long courses;
- "Bifidum Bag" - a probiotic in a concentrated, liquid form;
- "Acipol" - 10 million live bacteria in each capsule, quickly building up damaged intestinal tissue.
How to treat lactose intolerance in adults, if the symptoms appear only after the use of lactose? In this case, a special diet is prescribed. However, insufficiency in a strong form, accompanied by seizures, even in the absence of provocative foods in the diet, is eliminated only with medicines. The use of drugs is necessary in all cases of a secondary form of the disease, when the problem is provoked by inflammation of the intestine.
Adult Diet
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 required to completely remove dairy products from the diet. Milk and its derivatives contain a large number of trace elements, which are very difficult to replace. Often, missing components can only be filled with the use of special additives. Therefore, you should first try a lightweight version of the diet, built according to the following scheme:
- replacing cow's milk with goat's;
- proposed one-time intake of milk sugar (for example, a glass of whole milk) divided into 3-4 servings of several sips;
- periodically add a teaspoon of goodcream, completely replacing the consumption of fresh dairy products;
- Regular consumption of kefir or unflavoured yoghurts.
With a strong degree of lactose intolerance, the above measures of a restrictive diet are irrelevant - it will have to be eliminated completely and in any form.
Prognosis for lactase deficiency
If you do not take therapeutic measures and do not want to follow a diet, the development of dysbacteriosis is inevitable. In adulthood, this problem also gives rise to complications in the form of stable indigestion, constant belching and recurring attacks of pain.
In childhood (infancy) age, if parents ignore this disease, there are serious consequences, for example, speech is slowed down, physical development does not keep up with age, belated thinking is detected.
Is there a chance to step over the 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 symptom. When the body begins to respond positively to treatment and there are noticeable shifts in the reverse dynamics of the pathology, 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.
Geneticmilk aversions are forced to limit themselves to milk sugar all their lives. There are no drugs that block the effects of lactose on the body, so a strict dairy-free diet remains the only option for maintaining good he alth.
