Have you ever felt like you were an alien because of your food allergies. I do nearly every time I go into a restaurant because nearly everything has milk in it. There is certainly more awareness these days from our cafes and restaurants but it wasn’t always so widely accepted. There are many milk alternatives available for the most part, but you still have to ask and help people understand the severity of food allergies. It almost always takes me longer to order; running back and forth asking the chef questions and finally agreeing that the chef will make something to suit my food allergy needs. Meanwhile everyone at the tables thinks I am just being precious and incorrigible.
When you consider the consequences of ordering foods that you are allergic to, there is no question about it. You have to take care.
I have a few food allergies, I am gluten intolerant and do not eat sugar. In the case of lactose intolerance (milk sugar intolerance), the consumption of lactose-containing foods can lead to severe un-wellness for me, such as sinus congestion, headaches, flatulence and diarrhea. In fact, many of us have difficulty with lactose and don’t even know it. So in this article, we are going to try and shed some light on the subject and hopefully create some awareness for our readers.
What is milk sugar?
Milk sugar or lactose occurs naturally only in breast milk and in the milk of mammals. Lactose is made up of two sugar molecules linked together: glucose and galactose. The intestines can only absorb them as single sugars. Therefore, the consumed milk sugar must first be broken down into its components. This is done by an enzyme, known as lactase, located in the mucous membrane of the small intestine.
Both sugars – glucose and galactose – are important sources of energy and also serve as energy stores. Lactose also supports the absorption of the mineral calcium. The glucose absorbed by the small intestine reaches the cells via the blood. They use sugar to generate energy. Galactose is processed further in the metabolism, especially in the liver, and is also introduced into the energy balance.
Milk sugar intolerance: causes
Lactose or milk sugar intolerance is due to a deficiency or loss of activity of the enzyme lactase. It is caused by “developmental genetics”. In many people, the enzyme activity gradually weakens after the baby phase (hypolactasia): Their genetic makeup does not allow them to produce enough lactase for a lifetime. The consequence can, but does not have to be, primary lactose intolerance. A remaining lactase activity of around 50 percent is still considered sufficient.
Most of the time, the loss begins at the age of two. Symptoms typically appear over adulthood, less often in children. If lactose is avoided, the symptoms disappear. However, small amounts of lactose in food usually do not cause any problems. This is why medicines containing lactose, for example, are usually also suitable for people who cannot tolerate lactose well.
The frequency of the lactase deficit in the population varies. For example, in Europe from around 2 percent in Scandinavia to over 70 percent in southern Italy. In Australia, only 20% are suffering while worldwide it is estimated that 75% can’t handle lactose.
However, lactose intolerance can also occur as a result of various diseases: intestinal diseases (small intestine, large intestine) or changed conditions in the gastrointestinal tract, for example after an operation. Because here, among other things, a lactase deficit can occur. Again, milk sugar is no longer digested properly, there is a secondary lactose intolerance. If the cause can be eliminated and the lactase production has recovered, the intestine can cope with the milk sugar again.
Sometimes medication, for example prolonged treatment with antibiotics, also affects the intestinal functions and can trigger a lactase deficit, so that lactose is temporarily poorly tolerated.
Congenital lactose intolerance (congenital lactase deficiency) in infants is very rare. Healthy infants (unless they are born prematurely before the 34th week of pregnancy) are naturally optimally supplied with lactase. This enables them to digest breast milk, which contains a lot of milk sugar, and of course also bottled milk. Very few children are born with an absolute lactase deficiency (alactasia). The affected babies do not tolerate breast milk and become seriously ill in the first few weeks of life if intervention is not timed.
Symptoms of lactose intolerance
Bacteria in the colon ferment the undigested lactose. Various substances and gases are released, which soon cause discomfort in the stomach. That means: After eating dairy products – especially from cow’s milk, but also from milk from goats or sheep – and generally from lactose-containing foods, stomach pain, rumbling in the stomach and flatulence are not long in coming. Usually, the mishap begins promptly a quarter or half an hour after consumption, sometimes it lasts up to about two hours.
Since undigested lactose also binds more water in the intestine, diarrhea can also occur. Sometimes there are also various general symptoms such as headache, dizziness and nausea. How severe the symptoms are varies from person to person.
Diagnosis of lactose intolerance
Various specialists, often gastroenterologists, deal with the clinical picture: specialists in gastrointestinal medicine. The diagnosis is based on a hydrogen breath test, more precisely: an H. Here, after a twelve-hour break from eating, the patient drinks a certain amount of lactose dissolved in water and breathes into a test device. In the case of a lactase deficiency, the bacterial decomposition of milk sugar in the large intestine leads to the formation of hydrogen, which can be detected in the breath of those affected.
Another, older test (blood test) can be used to check how much dextrose (glucose), one of the two breakdown products of milk sugar, rises in the blood after drinking.
In addition, a genetic analysis can be used to find out whether you have a gene constellation that causes a lactase deficit. However, the hydrogen breath test is decisive for the diagnosis.
Therapy, self-help with lactose intolerance
In the case of lactose intolerance, it is recommended to limit the consumption of foods that contain a lot of lactose, depending on the tolerance. Sour natural yoghurts and certain long-matured cheeses are dairy products that, due to bacterial fermentation, contain almost no lactose. However, it is often added to industrially produced foods to improve the consistency. For example, it can be found hidden in many ready meals and sauces. Lactose-free milk products, which are available in large numbers and in large variety, offer a solution.
A lactose-free diet is not always necessary
In general, a maximum of ten milligrams (10 mg) of lactose per 100 grams of food is recommended for the declaration of lactose-free. It is considered to be well tolerated. However, a lactose-free diet is often not necessary at all. For example, many sufferers can even tolerate around ten to twelve grams (roughly equivalent to a glass of milk), especially if they consume this amount as part of a meal with other foods or spread over the day. If the residual activity of the lactase is very low, patients actually only tolerate very little lactose without experiencing symptoms. It is advisable to test your personal threshold yourself.
Lactase can also be substituted as a dietary supplement if necessary. Probiotics are also sometimes beneficial in this case.
A colonic can help after a Lactose reaction episode by cleaning out the residue and re-establishing healthy gut flora.