Secondary lactase deficiency in adults

More than half of all adults can not consume dairy products with impunity. Such an unpleasant surprise for a person who some time ago was free to drink fresh milk, is not a pathology, but an absolute norm. The thing is in lactase deficiency( in adults, it occurs, as a rule, in 7 cases out of 10), that is, in the loss of the body's ability to completely process milk sugar. This pathology is expressed in different ways and the consequences are most unexpected.

Mechanism of lactase deficiency

The substance of lactose, and in other words - milk sugar, which imparts a peculiar sweet taste to fresh milk products, is indispensable in the process of correct development of the child. However, before it begins to exert its positive influence, it is necessary to split it into simpler components, each of which is sufficiently independent. Separation of the element into glucose and galactose occurs in the GIT system under the influence of a special enzyme called lactase.

It is fully produced in the person's own intestinal environment. In a smaller part - enterocytes, tissues of the intestinal mucosa, and to a greater extent - bacteria responsible for the normalization of microflora. All of its functionalities are inherent in the constant separation of lactic acid into monosaccharides:

• glucose, which improves the digestion and absorption of micro- and macronutrients in the body of the baby, and also the correct intestinal algorithm is built;
• galactose, without which the formation of the central nervous system and the strengthening of the retina are not complete.

For infants, the norm is the incomplete digestion of lactose. However, the accumulation of it to excess volumes will speak directly about the lack of enzyme, in connection with which doctors diagnosed with lactase deficiency. How does the same pathology appear in adults?

Lactase disease in adults

Since the age of three years, the intensity of the enzyme activity has been decreasing, since most of it remains unclaimed. The cause of lactase deficiency in adults can become and acquired diseases, which will speak about its secondary form. This problem can hardly be called unsolvable, because all treatment consists in a simple refusal of dairy products.

Much more difficult, if the etiology of a lack of enzyme is a disease that must be detected and cured. Then lactase deficiency in an adult person serves as a signal, which must be paid attention, especially if it manifested itself suddenly.

Classification of the disease

An enzyme that breaks down lactose can be completely absent in the human body - and then they speak of a primary insufficiency that occurs quite rarely, in view of its genetic origin. This pathology arises with externally normal functionality of intestinal enterocytes, which is accompanied by their complete inability to produce lactase. Other variants of lactase deficiency in adults and children are usually a process of impairing or decreasing the activity of the existing enzyme: the

• functional form occurs in the case of a sufficient amount of lactase when the body is unable to process it completely;
• secondary lactase deficiency in adults passes after detection and elimination of the current disease, leading to the destruction or depersonalization of the enzyme;
• transient form is found in premature infants who did not pass through the activation of lactase, which is formed during the last term of pregnancy.

Most often, doctors in their practice encounter secondary lactase deficiency. In adults, it occurs several times more often than in children. And if in the latter the normal digestibility of milk sugar, as a rule, is restored after the treatment, then adult patients risk leaving a weak tolerance of lactose even after the therapy.

Causes of secondary lactase deficiency

The nature of the primary form of the disease lies in heredity - a person who has undertaken to study the origin of his own intolerance to milk, formed in the prenatal period, will always find a blood relative suffering from this pathology. However, this aspect is so single that the gene transfer is almost never confirmed.

Another thing is the secondary enzyme deficiency. Its formation is preceded by a clear deterioration in the work of the gastrointestinal tract as a result of a transferred( current) disease or reaction to an external factor. Possible causes of lactase deficiency in adults correspond to:

• prematurity;
• for diseases of the large or small intestine associated with viral infection or the presence of bacterial colonies;
• is a consequence of a cavitary operation, performed with involvement( cutting) of the intestine;
• by celiac disease;
• of Crohn's disease;
• overdose or rejection by the body of certain medicines.

The doctor can determine the exact origin of the pathology only after diagnosis. Laktaznaya failure in adults often goes after striking out the dairy product from the diet, so if no other human health problems do not bother, it is enough just to eliminate the intolerable element and dispense with the delivery of tests.

How to recognize the disease?

Self-diagnosis of a suddenly worsening state of health, especially if a person used lactose-containing substances shortly before the onset of anxiety signs, it is not difficult to conduct. Symptoms of lactase deficiency in adults immediately attract attention:

• nausea, less often - vomiting with an abundance of separated masses;
• gas formation, flatulence;
• severe diarrhea, accompanied by pain in the stomach and intestines;
• appearance of spots on the skin, rash;Heartburn, acidic belch;
• dizziness, weakness.

Typically, symptoms of lactase deficiency in adults appear no later than two hours after drinking milk. A characteristic accretive or paroxysmal condition occurs with an intensity proportional to the amount of the forbidden product, as well as the severity and form of the disease. Sometimes signs of lactase deficiency in adult patients with a small amount of milk consumed may not occur or manifest to a mild degree.

In other cases, the approaching poor state of health can be difficult to relate to the presence of lactose and can even be confused with toxic poisoning or cardiovascular problems. A person feels an increased hyperhidrosis, increased heart rate and difficulty breathing. Sometimes, in the background of a sudden surge of symptoms, loss of consciousness occurs.

Methods of primary diagnosis

The collection of symptoms and making an anamnesis is the first step in establishing a diagnosis, followed by initial testing with a restrictive diet. With the help of a doctor, a special diet is made that completely excludes the presence of lactose, and a time period during which control will be carried out. In parallel, a laboratory study of feces is conducted to assess the presence of carbohydrates there, which are known to form the basis of various sugars.

When it comes to the diagnosis and treatment of lactase deficiency in adults, you need to understand which doctor should be treated first, namely - to the gastroenterologist. Already in the direction from it may need the advice of an endocrinologist and other narrow specialists whose task will be to analyze the changes that have occurred in the body during the disease.

Analyzes for lactase deficiency

In Russia, the definition of lactase deficiency in both adults and children does not stand at such a level that at least one analysis gives an unambiguous answer to the presence of the disease and the degree of pathology. The most accessible, and therefore often the most commonly prescribed, analysis was and remains the feces collection and the study of it for carbohydrate content.

It is supposed to be that after the use of milk sugar in stool weights should not be present more than 0.25% carbohydrates. However, there is separate information for children of different ages, showing other figures. In addition, in the table of values ​​for adults there is no indication of which groups of carbohydrates should be considered, and which are considered insignificant and do not enter into the total percentage. For this reason, analysis is the role of one of the confirmatory studies, but often it is the only one.

Another method gives a greater percentage of the probability of determining the diagnosis and contributes to a more accurate appointment of treatment for lactase deficiency in adults and children - this is a biopsy technique, that is, taking a sample of small intestine tissue. It is invasive and has significant traumatism, therefore it is infrequent and especially infrequent for children, since it involves the use of anesthesia.

The next study, the lactose curve, is controversial, since it involves taking a dose of milk sugar on an empty stomach, followed by tracking the change in blood glucose level. With a strong reaction to lactose, the analysis becomes dangerous, but it is considered several times more reliable than stool examination, which sometimes justifies the risks.

The sample for the amount of hydrogen in the exhaled air mass is considered the most expensive and therefore not always justified. The patient is given milk sugar, and then at regular intervals follow the data obtained from the exhaled air on the sensors of the device.

Treatment of

Before beginning active treatment of lactose deficiency in adults, gastroenterologists recommend the restoration of the intestinal microflora affected by disorders caused by the use of the forbidden product. To replenish a healthy bacterial environment that maintains the optimal acidity of the body, the following are prescribed:

• "Bifidumbacterin" is a probiotic with a bacterial medium already grown and ready for action, which must be taken by several long courses;
• "Bifidum Bag" - a probiotic in a concentrated, liquid form;
• "Acipol" - 10 million living bacteria in each capsule, quickly overbuilding damaged intestinal tissues.

How to treat lactase deficiency in adults, if symptoms only appear after using lactose? In this case, special dietary meals are prescribed. However, the lack of a strong form, accompanied by attacks even when there are no provocative products in the diet, is eliminated only by medications. The use of medicines is necessary in all cases of the secondary form of the disease, when the problem is provoked by inflammation of the intestine.

Adult diet

With a mild to moderate degree of disease, which is well defined by the body's response to the effects of taking lactose, it is not necessary to completely remove dairy products from the diet. Milk and its derivatives contain a large number of trace elements, which are very difficult to replace. Often, the missing components can be filled only by the use of special additives. Therefore, you should first try a light version of the diet, built according to the following scheme:

• replacing cow's milk with goat;
• the proposed one-time intake of milk sugar( for example, a glass of whole milk) divided into 3-4 servings a few sips;
• periodically add a teaspoon of good cream to tea or coffee, completely replacing it with the use of fresh dairy products;
• regular consumption of kefir or yogurt without flavor additives.

With a high degree of lactose intolerance, the above restrictive diet measures are irrelevant - it will have to be eliminated completely and in any form.

Prognosis for lactase deficiency

In case of rejection of medical measures and unwillingness to follow a diet, the development of dysbacteriosis is inevitable. In adulthood, this problem also causes complications in the form of stable indigestion of the stomach, a constant eructation and recurring episodes of pain.

In childhood( infant) age, if the parents ignore this disease, serious consequences occur, for example, speech is decelerated, physical development does not have time after age, and the belatedness of thinking is revealed.

Is there a chance to step over the pathology and return to the usual diet? In the secondary form of the disorder, the resumption of a normal lifestyle is possible almost immediately after the cure of the underlying disease, in which lactase deficiency existed as a concomitant symptomatology. When the body begins to respond positively to treatment and noticeable shifts in the reverse dynamics of the pathology are experienced, it is possible to try to introduce into the ration small amounts of sour-milk products. Increase the amount of lactose should be gradually and with constant monitoring of one's own well-being.

Holders of genetic milk rejection have to limit themselves in milk sugar all their life. Drugs that block the effects of lactose on the body, there is no, so a rigid dairy-free diet remains the only option for maintaining good health.