More than 12 million people in Germany cannot digest milk properly. Diarrhea, nausea, indigestion and abdominal pain are the consequences. The cause of lactose intolerance (milk sugar intolerance) is the absence or insufficient activity of the digestive enzyme lactase. This enzyme breaks down milk sugar (lactose) into its components glucose and galactose at the lining of the human small intestine.
What happens in the intestine in lactose intolerance?
If this function is disturbed, the lactose enters the colon, which is populated with bacteria, and serves as food for the colon bacteria. The lactose and the short-chain fatty acids produced during bacterial fermentation lead to an influx of water into the colon.
The stretching stimulus simultaneously stimulates intestinal motility. Depending on the extent of lactose intolerance, the resulting symptoms range from flatulence and bloating to cramping abdominal pain and watery diarrhea.
Congenital or acquired?
While the incidence in Germany is 15 percent, 90 to 100 percent of residents in Asia suffer from lactose intolerance. Worldwide, more than 50 percent of the population is affected. It is important to know that lactose intolerance is not an allergy, but an enzyme deficiency disease.
In addition to a primary or congenital lactase deficiency, which manifests itself in infancy, a distinction is made between acquired or secondary lactase deficiency. Acquired lactase deficiency in adults can develop with previously normal lactose tolerance due to diseases of the small intestine such as Crohn’s disease or celiac disease.
Other triggers include:
- Bacterial infections
- Fungal infections of the intestine
- Influenza of the intestine
- Stomach and intestinal surgery
- The administration of antibiotics or cytostatics
The exact cause of loss of enzyme activity in adulthood is not known.
Lactose intolerance is often detected late
Although about twelve million people in Germany are affected by lactose intolerance (lactose intolerance), the disease ekes out a shadowy existence: Often years pass until the correct diagnosis of lactose intolerance.
Those who visit a doctor because of their complaints, especially diarrhea and flatulence, often experience a bitter disappointment. The road to the correct diagnosis of lactose intolerance is long, often years pass before a simple but successful nutritional therapy is started.
Symptoms of lactose intolerance
Timely recognition of lactase deficiency would save many a desperate, long-suffering patient from unpleasant examinations or even embarrassment diagnoses of, for example, psychosomatic illness. The non-specific and individually variable symptoms following the consumption of lactose-containing foods provide clues to the disease. These include:
- Diarrhea
- Feeling of fullness
- Flatulence
- Cramp-like pain
- Bowel sounds
- Fatigue
- And even depressive moods
Diagnosis is made by means of breath test
Diagnosis is made by the lactose load test or H2 breath test. If the lactase deficiency is congenital, the patient must adjust to a permanent change in diet. If it occurs only with advancing age and in association with one of the triggers mentioned above, treatment of the underlying disease will result in significant improvement of symptoms.
