This particular intolerance is not a food allergy, but an incompatibility of dairy products that is caused by an enzyme deficiency in the affected individuals. Intolerance to lactose should not be confused with the much less common cow's milk allergy.
What happens with intolerance?
Lactose consists of mucilage (galactose) and glucose (glucose), so lactose is a disaccharide or a double sugar. Lactose is absorbed via the intestinal mucosa. To be digested, the lactose must be completely broken down in the small intestine. In order for the breakdown of all components to be done properly, it needs the enzyme lactase. The lactose can only be completely digested if the enzyme lactase works properly. If the enzyme does not work properly or if it is completely absent, the affected person suffers from lactose intolerance.
Cleavage in the small intestine
If the lactose is not split in the small intestine, then the double sugar gets into the colon. There, the intestinal flora is settled, which consists of a variety of bacteria. The bacteria recognize the milk sugar as food and it comes to the metabolism. This produces many acids and gases. Gas production can cause the person to suffer from nausea and diarrhea, and the unpleasant feeling of being bloated. These signs of intolerance occur whenever something is not intact in the gastrointestinal tract. In lactose intolerance, the disease is caused by the accumulation of degradation products that arise in the colon during lactose processing by the bacteria.
Always let clarify
However, similar complaints can also occur in gastrointestinal system diseases and in many food intolerances. Precisely for this reason, the symptoms are often not immediately associated with intolerance to lactose. If the person drinks milk or milk products and immediately symptoms such as bloating, loud bowel sounds, intestinal wind, diarrhea, vomiting and abdominal pain occur, then a lactose tolerance test should be carried out immediately. Only in this way can intolerance be clearly demonstrated. Such a test is usually carried out on the basis of the hydrogen breath test, because the gases in the intestine arising due to intolerance also diffuse into the blood and are then exhaled, namely via the lungs.
How is intolerance determined?
The exact causes of intolerance to food are not always easy to determine. There are several tests to determine intolerance to lactose. So there is above all the diet or omission test. Here, the person dispensed on all drinks and foods that contain the double sugar. If the symptoms improve as a result of omitting the dairy products, this can certainly be a first indication of intolerance.
Preparations for the test
Write a diary.
The person concerned keeps a food diary during this time, in which everything he eats and drinks is meticulously recorded. After a certain symptom-free phase, the stress test follows. Here it is checked whether the person after drinking milk or after eating dairy again suffers from the usual symptoms. If the results are not clear, the breath test will be performed. The hydrogen content of the exhaled air is measured, before and after drinking a lactose solution.
Every 15 to 30 minutes, the test is repeated over a period of two to three hours. However, bad oral hygiene, chewing gum, smoking, or other factors can falsify the test result. Therefore, care should be taken to see if the symptoms are really caused solely by the intake of the sugar solution. In the lactose tolerance test, the sugar level in the blood is determined after drinking the milk sugar liquid. On lactose intolerance, the result indicates, because if the blood sugar level does not rise thereafter, then the lactose is not split due to a lactase deficiency. As a result, there are no sugar components that the body would be able to absorb.
What can be done against lactose intolerance?
Certainly, a conscientious and consistent change in diet brings the best success. However, this is a huge challenge for most of those affected, because those who switch to a lactose-free or low-lactose diet will have to do without many products. It is also not always obvious which products contain lactose. For several years, it has been required by law that the ingredients must be noted on all products. All those products where the list of ingredients includes terms such as milk, lactose, whey powder or lactose should be avoided or at least carefully tested.
Not all dairy products contain (much) lactose
When bakers or butchers should be inquired, whether in the processing milk, whey powder or lactose were used. But only very few of them have to completely dispense with all products that contain lactose; this is all about individual compatibility. Certain cheeses can be easily consumed by lactose-intolerant people, as more mature types of hard cheeses and acidified milk products already contain bacteria that largely reduce lactose during the ripening process. These include cottage cheese, sour milk, buttermilk and certain yoghurts. Thus, even lactose-intolerant people certain dairy products are quite digestible.
It is also important to look for hidden lactose in bread, sausages and finished products. Checking with a nutritionist or a qualified dietician is recommended. It is also possible to take the missing enzyme in the form of lactase tablets. However, there is no health insurance refund and the drugs are unfortunately quite expensive.
lactose-free or low-lactose foods
Lactose-free or low-lactose foods include rice milk, all cereals, nuts and legumes, fresh fruits and vegetables, meat and poultry, boiled eggs, seafood and fish, mineral water, fruit juices, herbs and spices, etc.
The lactose-containing foods include u. a. Dairy products such as milk, butter, yoghurt and cheese. Finished products, sweets, medicines, mashed potatoes, spice mixes, baked goods and sausages may well contain lactose, which causes discomfort when consumed.