Can You Become Lactose Intolerant All Of A Sudden?

Lactose intolerance is a digestive problem that results in indigestion of lactose upon its consumption. It is a very common problem affecting about 75% of the world population and about 25% of the Americans.

What Is Lactose?

Lactose is a disaccharide that is broken down by body into glucose and galactose by an enzyme called lactase. Mammalian milk is rich in lactose that is responsible for nourishment of most of the animals, including human babies. Lactase, an enzyme, is found at the small intestine brush border where it is responsible for the digestion of lactose. The activity of lactase is at its peak at the time of birth for digestion of lactose because breast milk is the only source of nutrition. With growing age, the activity of lactase enzyme is also reduced as the child learns to nourish from other sources. The individuals who still have persistence of lactase enzyme fall in the group of lactase persistence, whereas, those who exhibit reduced activity of lactase fall in lactase non-persistence group.

Can You Become Lactose Intolerant All Of A Sudden?

Thus, the reduced activity of lactase leads to maldigestion/indigestion of lactose. The reduction in the activity of lactase happens over an extended period of time, usually after 2 to 12 years of age, so in most cases lactose intolerance is a slow process; however, it can happen suddenly, which is rare and uncommon, but not impossible. In most cases, lactose intolerance is not sudden because the down regulation of lactase does not happen suddenly and happens in time. Lactose intolerance is common in Asian, African, Southern Europe and Middle East region. It is less commonly seen in people who practice domestication of cattle and are dependent on unfermented milk and dairy products as an important source of food. People from northern Europe maintain this capacity to digest milk and dairy products and lactose intolerance is rarely seen in descendants of this region.

How Does Lactose Intolerance Occur?

Lactose intolerance occurs in 75% people all around the world by genetically programmed reduction in lactase synthesis that is an enzyme responsible for lactose breakdown as a part of maturation. It is generally seen around the age of 20-40 years of life. This is known as primary lactase deficiency. In addition, some people suffer from gastrointestinal disorders such as inflammatory bowel disease, gastrointestinal infections (infectious enteritis), abdominal surgeries, celiac disease, Crohn’s disease and other health disorders that cause reduced lactase activity, which is known as secondary lactase deficiency. Primary as well as secondary lactase deficiency should be excluded from congenital lactase deficiency, which is a rare autosomal recessive disorder that affects exclusively infants and may prove fatal to them if not detected early in life. In all these cases of lactose intolerance, the lack of lactase enzyme leads to malabsorption/inabsorption of lactose present in intestines, which increases the water content in intestines and the fermentation of colonic microflora leads to production of gases (such as hydrogen, carbon dioxide and methane) along with short chain fatty acids that causes lactose intolerance. This causes symptoms of abdominal pain, bloating, diarrhea, abdominal cramping, and flatulence.

How is Lactose Intolerance Diagnosed?

Lactose intolerance is diagnosed by endoscopic duodenal biopsy that is the gold standard for detecting lactase deficiency. Other tests include genetic tests and lactose hydrogen breath tests and lactose tolerance tests.

What is The Treatment of Lactose Intolerance?

Lactose intolerance has no permanent treatment, but can be managed with the aim at improving gastrointestinal symptoms along with reducing malabsorption. The improvement of gastrointestinal symptoms is achieved by modifying diet and restricting lactose and FODMAP (fermentable oligosaccharide disaccharide monosaccharide and polyols) in ones diet along with maintenance of adequate calcium intake that is important in preventing secondary bone disease in patients with restricted milk and dairy diet. This can be achieved with calcium replacement through other foods rich in calcium or calcium supplements. Another management approach to lactose intolerance is replacement with lactase enzyme.

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