Mattar et al. 2012. ‘Lactose intolerance: diagnosis, genetic and clinical factors.’ Accessed March 28, 2013. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401057/
Lactose intolerance: diagnosis, genetic and clinical factors:
Lactose is a carbohydrate found in milk. This disaccharide is made up of glucose and galactose subunits. Seventy five percent of the world’s population loses their ability to breakdown the disaccharide into monosaccharide units that are easily digested. Lactase is the enzyme that breaks down lactose products. In infants breakdown is at its max from birth till 2 years. An aging person can fall into a group of lactase non-persistence (hypolactasia) or lactase-persistence activities. Reduction in lactose renders persons lactose intolerant that develop symptoms in identifying the presence of this diagnosis.
Individuals with hypolactasia and lactase persistence have identical coding sequences which were confirmed in a study where DNA was collected from subjects in various parts of the world. The LCT-13910CT and LCT-13910TT genotypes were associated with the lactase-persistence phenotype. This indicates that it dominates the person where they is a lactose digester. If the genotype was LCT- 13910CC and LCT-13910T is absent the person suffers from lactose mal digestion.
The first method for detection of lactose mal digestion was direct biochemical assay of lactase activity from a jejunal sample. This was performed using a glucose oxidase reagent which detects glucose molecules present in the lactose. This method has been replaced by endoscopic duodenal biopsy. The lactose breath test is also a method for determining the presence of lactose in the body. It is based on fermentation of undigested lactose by intestinal flora producing hydrogen, carbon dioxide and methane which is absorbed and eliminated via the lungs. The result of these gases is bloating, abdominal pain, and diarrhea. Undigested lactose acidifies the colon and increases diarrhea while some may experience constipation.
A false-negative result can occur if antibiotics have been recently consumed within one month of testing or if the pH is too acidic to inhibit bacterial activity or if there has been bacterial growth. The genetic test provides a more direct result where hypolactasia or lactase persistence genotype is found. This was formed due to the discovery of lactase-persistence alleles. This method was deemed better than the breath test since there is no cut off level or dependence on the amount of lactose or influenced by the duration of the test and age of the individual.
Individuals suffering with this problem need to maintain their intake of calcium due to their restricted milk diet. A deficient in calcium result in bone diseases. A key to management of lactose intolerance is a recommended of no more than 20g of lactose without significant symptoms. A person’s diet changes where they would have to consume it with other foods and prevent lactose tablets. Supplements of calcium and vitamin D are produced which may be expensive to the consumer. Yoghurt containing live cultures providing endogenous beta galactosidase is an alternative source of calories and calcium and is well tolerated by many lactose-intolerant patients. Lactose hydrolyzed milk is another safe source for patients.
This article cleared up the effects of an individual suffering from the absence of the enzyme called lactase which breaks down lactose found in dairy products such as milk. It enhances the symptoms of a patient suffering from lactose intolerance and deals with the different mechanisms of detecting lactose in the body and suggests which method is better due to the information gathered.
Hope you learned something as well…