This document discusses lactose intolerance. It begins by defining lactose as a disaccharide composed of glucose and galactose that is found in human milk and digested by the enzyme lactase. It then notes that lactose intolerance is the inability to digest lactose due to lactase deficiency. The main symptoms of lactose intolerance are abdominal bloating, cramps, flatulence, and diarrhea. The document discusses the different types of lactase deficiency and notes that diagnosis involves dietary and medical history as well as hydrogen breath tests. Management of lactose intolerance involves avoiding lactose-containing foods and using alternative milk products.

1. LACTOSE INTOLERANCE
PRESENTOR : DR.KARAN R RAWAT

2. Lactose
 Lactose is a disaccharide of β-D-
galactose and β-D-glucose in β(1,4)
linkage.
 Human milk contains 200mmol/lit of
lactose.
 It is digested by enzyme lactase to
form glucose and galactose in the
brush border of the intestine.

3. Lactose containing food stuffs
 Fresh, skimmed , non fat and
condensed milk.
 Cream
 Yoghurt
 Cheese
 Processed foods
 Stuffings
 Salad dressings etc.

4. Lactose intolerance
 Lactose intolerance, also called
lactase deficiency or hypolactasia,
is the inability to digest and metabolize
lactose, a sugar found in milk.
 Lactose intolerance is not an allergy
because it is not an immune response
but caused by lactase deficiency.

5. Lactose intolerance
 Lactose intolerance can occur in any
age group or population.
 However, people of African, Jewish,
Hispanic, Asian, Middle Eastern and
Native American descent, Caucasians
are at risk for developing lactose
intolerance.

7. Symptoms
 Abdominal bloating and cramps
 Flatulence
 Diarrhoea
 Nausea
 Borborygmi (rumbling stomach)
 Vomiting (particularly in adolescents).

8. Types of lactase deficiency
 Primary lactase deficiency is a
genetically determined absence or
decrease in the enzyme is noted.
 Jejunal morphology is normal.
 In non caucasian groups, primary
lactase deficiency is abnormal in
adulthood.

9. Secondary lactase deficiency
 Secondary, acquired, or transient
lactase deficiency is due to the small
intestinal mucosal disease,
abnormalities of brush border cells
and transport processes.
 It is often associated with celiac sprue.

10. Congenital lactase deficiency
 Congenital lactase deficiency is a
very rare, autosomal recessive genetic
disorder that prevents lactase
expression from the first feed.
 Congenital lactose intolerance is
serioue disorder in which the infants
may fail to thrive unless given lactose
free formula feed.

11. Diagnosis
 Dietary history of the patient who are
complaining flatulance , abdominal
pain , diarrhoea.
 Familial history of the patient.
 Check whether the patient has
underwent partial gastrectomy and
other related procedures.
 Tests – stool acidity test, hydrogen
breath tests.

12. Misdiagnosis
 Irritable bowel syndrome
 Crohn's disease
 Food poisoning
 Gastroenteritis.
 Celiac disease.

13. Management
 Avoiding lactose-containing products
 Alternative products such as Plant-
based milks and derivatives are
inherently lactose free: soy milk, rice
milk, almond milk, hazelnut milk, oat
milk, hemp milk, peanut milk,
horchata.