General Practice 2022

Intolerância à lactose: what é, symptoms, types and treatment

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Intolerância à lactose: what é, symptoms, types and treatment
Intolerância à lactose: what é, symptoms, types and treatment

Lactose intolerance is a syndrome caused by the decrease or lack of lactase in the body, which is the enzyme responsible for the digestion and absorption of lactose, a sugar present in milk and dairy products such as yogurt, butter, ice cream and cheeses.

This difficulty in digesting and absorbing lactose can cause some signs and symptoms, such as abdominal bloating, excess gas, diarrhea, belly pain and headache. Learn about other signs and symptoms of lactose intolerance.

Lactose intolerance can arise in the first days of life, in adulthood, or it can happen due to the presence of situations, such as chemotherapy treatment, Crohn's disease or gastroenteritis, for example.The diagnosis of lactose intolerance is made by a doctor, who will evaluate the signs and symptoms, and order tests and tests, such as breath and oral tests, and blood and stool tests.

Main signs and symptoms

The main signs and symptoms of lactose intolerance are:

  • Excessive gas;
  • Tummy pain;
  • Diarrhea;
  • Nausea;
  • Headache;
  • Swollen belly;
  • Tiredness;
  • decreased concentration and memory;
  • Muscle or joint pain.

In addition, in more severe cases, lactose intolerance can also cause weight loss, dehydration, child growth retardation and death.

Types of lactose intolerance

According to age and the presence of some he alth conditions, lactose intolerance can be classified as primary, secondary or congenital:

1. Congenital lactose intolerance

This type of intolerance is very rare and appears in the first days of life after the ingestion of lactose, through breast milk, when the mother consumes milk and derivatives, or the ingestion of other types of milk, causing intense diarrhea, vomiting, dehydration and difficulty gaining weight.

Genetic lactose intolerance happens when the baby's body is unable to produce the lactase enzyme due to a genetic alteration, being a serious situation that, if not identified early, can lead to death.

2. Primary lactose intolerance

This type of lactose intolerance is the most common and happens due to a decrease or lack of the lactase enzyme in the intestine, caused by a natural process of the body over the years.

However, in some adults, genetic changes may occur that maintain the normal production of lactase, allowing the digestion of lactose and preventing the onset of intolerance.

3. Secondary lactose intolerance

Secondary lactose intolerance is a condition that can be temporary and is caused by damage to the cells in the intestine responsible for producing the enzyme lactase, as in the case of rotavirus, gastroenteritis, medications (antibiotics and chemotherapy), radiation therapy, chronic diarrhea, celiac disease, bacterial intestinal infections.

Possible causes

Lactose intolerance can be caused by a genetic change that prevents the production of the lactase enzyme or it can be caused by the natural decrease in the production of the lactase enzyme with advancing age.

In addition, some conditions that cause damage to intestinal cells, such as chemotherapy or radiation treatments, the use of oral antibiotics, chronic diarrhea, Crohn's disease, bacterial, viral and protozoal infections such as giardia and amoeba, can also cause lactose intolerance.

Difference between CMPA and lactose intolerance

Cow's milk protein allergy, or CMPA, is an immune system reaction to one or more proteins present in cow's milk, such as casein, lactoglobulin, lactalbumin, serum albumin and immunoglobulins.

APLV occurs when you ingest or have skin contact with products, such as cow's milk and its derivatives, such as ice cream, cheese, butter and cakes, causing the appearance of signs and symptoms, such as hives, vomiting, diarrhea and child growth retardation. Know other symptoms of CMPA.

Lactose intolerance is a difficulty that the body has to digest and absorb lactose, due to the decrease or absence of the lactase enzyme in the intestine, causing mainly symptoms such as excess gas, abdominal pain and diarrhea.

How to confirm the diagnosis

The diagnosis of lactose intolerance must be made by a doctor, who will evaluate the signs and symptoms and the person's he alth history, and may also recommend the removal of foods with lactose, such as milk, yogurt and cheeses, from the diet, for 2 weeks to see if there is improvement in symptoms.

In addition, the doctor may also order some tests to confirm the diagnosis, check the possible causes and the amount of lactase that the body still produces, such as breath test, oral lactose tolerance test, stool exam and of blood. See all exams and tests to diagnose lactose intolerance.

How the treatment is done

The treatment of lactose intolerance should be done under the supervision of a doctor and a nutritionist, where it is recommended to reduce or exclude the consumption of milk and its derivatives, such as butter, yogurt, cheese and ice cream. See other foods that should be avoided or excluded in lactose intolerance.

In primary intolerance, the recommendation is to reduce the consumption of lactose, maintaining a maximum of 15 g of lactose per day, which is equivalent to 300 ml of milk or 300 g of yogurt, for example, which should be divided in 2 meals or more throughout the day.However, reducing the amount of milk and dairy products in the diet may not reduce the signs and symptoms of intolerance in some people, and it is recommended to take the lactase enzyme along with meals that contain lactose.

In cases of secondary intolerance, it may be advisable to totally exclude milk and its derivatives from the diet for 1 month or more, until the intestines recover. However, this exclusion must always be guided and accompanied by a doctor or nutritionist, to avoid deficiency of important nutrients, such as calcium, vitamin D, vitamin A and phosphorus.

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