Lactose is a disaccharide sugar found naturally in milk. It is also known as milk sugar. It is broken down by an enzyme called lactase, secreted in the intestines. If the intestinal lactase enzyme is insufficient or not functioning properly, a condition called lactose intolerance occurs.

Lactose intolerance is a very common condition and can affect a large portion of the population. It's estimated that up to 75% of the population is affected by the condition. People with lactose intolerance can experience severe digestive problems when consuming milk and dairy products. This condition typically manifests as digestive issues such as abdominal pain, bloating, gas, diarrhea, or constipation.

The quality of life of people with lactose intolerance can be affected. Therefore, avoiding lactose-containing foods or using lactase enzyme supplements can help alleviate symptoms. Changing dietary habits to include lactose-free or low-lactose alternatives can help manage symptoms. These individuals often adapt their lifestyles by avoiding lactose-containing foods and opting for alternative diets.

What is lactose intolerance?

Lactose intolerance is a digestive disorder caused by the inability to digest lactose, a primary carbohydrate found in milk. This condition is usually caused by a deficiency or deficiency of the lactase enzyme in the body. Lactase breaks down lactose into simple sugars called glucose and galactose, enabling their absorption.

Individuals with lactose intolerance either don't produce enough of the lactase enzyme or don't function properly. In this condition, lactose can't be broken down and absorbed in the intestines. As a result, lactose can cause various digestive problems as it passes through the intestines. Symptoms typically include bloating, gas, abdominal pain, diarrhea, or constipation.

This condition is usually present from birth, and some individuals may experience lactose intolerance throughout their lives. The prevalence of lactose intolerance can vary across populations. A common estimate is that a large portion of the population, approximately 75%, may be affected. However, rates can vary depending on geography, ethnicity, and age. For example, lactose intolerance is generally less common in children under 5.

What are the types of lactose intolerance?

Lactose intolerance is generally divided into two main types: primary and secondary lactose intolerance.

• Primary lactose intolerance: This is the most common form of lactose intolerance, which develops with age and is caused by decreased lactase enzyme production. It is usually genetic, and lactase enzyme production decreases with age. This condition is particularly prevalent in certain ethnic groups. For example, it is more common in Asian and African communities than in Europeans. People with primary lactose intolerance may experience progressive difficulty digesting lactose throughout their lives.
• Secondary lactose intolerance: This type of lactose intolerance is caused by digestive diseases or other intestinal disorders. For example, conditions such as Crohn's disease, irritable bowel syndrome (IBS), celiac disease, or certain infections can cause inflammation or damage in the intestines, reducing the production of the enzyme lactase. In this case, the amount of the enzyme normally needed to digest lactose is not produced, and lactose intolerance can develop.

Secondary lactose intolerance can be temporary or permanent, often due to the presence of a specific disease. With treatment or management of these diseases, lactose intolerance symptoms may also decrease or disappear once the intestinal inflammation or damage is resolved.

What are the symptoms of lactose intolerance?

Lactose intolerance often causes digestive symptoms and can manifest in a variety of ways. The most common symptoms include:

• Bloating: A feeling of discomfort, fullness, or bloating in the abdominal area.
• Abdominal Cramps: Abdominal pain, abdominal cramps, or discomfort.
• Diarrhea: Liquid stools resulting from undigested lactose absorbing water in the small intestine.
• Gas: Gas produced by bacteria in the intestines fermenting undigested lactose.
• Constipation or other intestinal problems: In some cases, symptoms such as constipation, painful defecation, urgent need to go to the toilet, nausea, and vomiting may also be observed.

The severity of symptoms may depend on a person's level of lactose tolerance and the amount of milk and dairy products they consume. Some people can tolerate small amounts of lactose, while others cannot tolerate larger amounts. The severity and impact of symptoms can vary from person to person. In some cases, symptoms may be mild, while in others, they may be more pronounced and bothersome.

What are the causes of lactose intolerance?

Lactose intolerance is caused by an inability to digest the milk sugar called lactose (a disaccharide). This condition occurs due to a deficiency or complete absence of the enzyme lactase, which is required in the intestines. Lactose intolerance usually occurs for the following reasons:

• Lactase deficiency: Lactose intolerance is usually caused by insufficient production or a lack of the enzyme lactase. Lactase breaks down lactose into simple sugars called glucose and galactose, which the body can absorb. Insufficient lactase cannot break down lactose effectively, leading to lactose accumulation in the intestines and digestive problems.
• Genetic factors: Some people have a genetically determined decrease in lactase production. This may be more common in certain ethnic groups.
• Intestinal problems: Intestinal disorders, damage to the intestinal wall, inflammation or infections can affect the production of lactase enzyme and cause lactose intolerance.
• Age-related factors: Some people experience a decrease in lactase enzyme production as they age. This may lead to the development of lactose intolerance in adulthood or older age.
• Consuming milk and dairy products: People with lactose intolerance experience digestive issues when consuming milk and dairy products. Therefore, individuals with lactose intolerance should avoid dairy-containing foods such as milk, yogurt, and cheese, or consume them within their tolerance levels.

For people with lactose intolerance, a dietary plan may include avoiding foods that contain lactose. However, it's important to replace milk and dairy products with alternatives that contain nutrients like calcium, B12 , vitamins A, and D. These include fruits, tofu, soybeans, leafy green vegetables (e.g., kale, broccoli), and lactose-free or low-lactose alternatives like almond milk.

How is lactose intolerance diagnosed?

Diagnosing lactose intolerance typically begins with observing symptoms and examining the symptoms that occur after consuming lactose-containing foods. In addition to these symptoms, various tests may also be used:

• Stool acid test: Undigested lactose is fermented by bacteria in the intestines, producing lactic acid. Measuring stool lactic acid can help identify lactose intolerance. This test must be performed under specific conditions, as the stool must be fresh.
• Hydrogen breath test: Undigested lactose causes hydrogen production in the intestines. This test involves measuring the breath at regular intervals after consuming a lactose-containing food. In people with lactose intolerance, high hydrogen levels can be detected in samples taken from pouches.
• Lactose tolerance test: In this test, a person is given foods containing lactose and their blood glucose levels are measured. Normally, digestion of lactose-containing foods results in an increase in blood glucose levels. However, individuals with lactose intolerance do not experience this increase.
• Endoscopy biopsy: One of the most reliable methods for definitive diagnosis is the examination of a tissue sample taken from the intestine during an endoscopic procedure. This method can detect lactase deficiency in intestinal tissue.

Each test and its interpretation should be performed by a physician or specialist. A correct diagnosis is made by evaluating the individual's symptoms, medical history, and test results together.

What are the treatment methods for lactose intolerance?

Lactose intolerance treatment methods include various strategies to alleviate and manage symptoms. The most basic and effective method is to avoid lactose-containing foods. However, eliminating milk and dairy products from the diet can lead to calcium, vitamin B12 , and protein deficiencies. Dietitians or doctors can prescribe supplements to address these deficiencies.

• Enzyme supplements: Tablets or preparations containing the enzyme lactase can aid in the digestion of lactose. While these supplements may be effective for some individuals, they may not be effective for everyone.
• Lactose intolerance: People with lactose intolerance can adjust their bodies by consuming lower amounts of lactose. Some studies have shown that lower doses can reduce symptoms.
• Probiotic and prebiotic therapy: Probiotics, which provide beneficial bacteria to the digestive system, and prebiotics, which support the nutrition of these bacteria, can alleviate symptoms. Certain microorganisms, such as Bifidobacteria, are thought to be particularly effective.

Treatment methods for lactose intolerance can vary depending on an individual's symptoms and body response. It's important to consult with a doctor or specialist before using any treatment method. This will allow for a personalized treatment plan to be developed and symptoms to be managed more effectively.

What is good for lactose intolerance?

Proper treatment and nutrition program are crucial for individuals with lactose intolerance. Individuals living with this condition should first undergo the necessary tests at a healthcare provider and then adapt to the nutrition program recommended by a dietitian or specialist. Untreated lactose intolerance can cause severe digestive problems over time, and these problems can be prevented with appropriate treatment.

The recommended diet plan for individuals with lactose intolerance may not include a diet free of milk and dairy products. However, milk and dairy products are important sources of calcium, vitamins B12 , A and D, and protein. Deficiencies in these nutrients can lead to serious health problems. Therefore, individuals with lactose intolerance should develop a nutritional plan under the supervision of a specialist that provides adequate amounts of other protein sources and the vitamins they are lacking.

However, probiotics, when used with expert advice and monitoring, can contribute to digestive system function. Probiotics containing Lactobacillius Bulgaria and Streptococcus Thermophilus, in particular, can be effective in digesting lactose.

For individuals with lactose intolerance, it's crucial to develop a proper nutritional plan and have it regularly monitored by a specialist. This allows the body to absorb missing nutrients and minimize health problems through nutrition. However, in every case, a treatment and nutrition plan should be developed based on individual health conditions and needs. Therefore, it's recommended that everyone consult a specialist to develop a personalized approach.

What should lactose intolerant people not eat?

People with lactose intolerance should be mindful of certain dietary considerations. They are advised to avoid foods containing lactose and avoid foods that may trigger symptoms. These foods may include:

• Milk: For those with lactose intolerance, milk can cause symptoms because it contains lactose. Therefore, all types of milk, such as cow's milk, goat's milk, and sheep's milk, should be avoided.
• Dairy products: Foods made from milk, such as cheese, yogurt, ice cream, and cream, also contain lactose and can cause digestive problems for people with lactose intolerance.
• Ready-made foods: Ready-made foods such as cakes, biscuits, chocolate, pastry often contain dairy products and can trigger symptoms of lactose intolerance.
• Creamy or milk-based sauces: Creamy or milk-based sauces used in some dishes may also contain lactose, so consumption of such foods is not recommended.
• Foods with hidden lactose: Some packaged or processed foods may contain hidden lactose. Therefore, it's important to read food labels carefully and check the ingredients.

People with lactose intolerance should avoid consuming foods that can trigger symptoms as much as possible. However, some studies have shown that certain amounts of dairy products do not cause symptoms. For example, consuming just one glass of milk may not significantly increase symptoms in some patients. However, considering their symptoms and tolerance levels, these individuals should consider consuming lactose-containing milk and dairy products under the supervision of a specialist. While small amounts of lactose-containing milk or kefir can be consumed under the guidance of a specialist, it's important not to exceed specific serving sizes.

What happens if lactose intolerance is left untreated?

Lactose intolerance occurs due to difficulty digesting lactose and is typically associated with the consumption of milk and dairy products. If left untreated or appropriate measures are not taken, it can lead to digestive problems and discomfort in individuals with lactose intolerance.

If left untreated, lactose intolerance symptoms can be serious and impact a person's quality of life. Symptoms can include digestive issues such as nausea, abdominal pain, bloating, gas, diarrhea, or constipation. These can negatively impact daily life and restrict a person's eating habits.

If lactose intolerance is left untreated, chronic digestive problems and recurring symptoms may inevitably occur. Nutritional deficiencies may also occur, as milk and dairy products are important sources of calcium, vitamins B12, A and D, protein, and other nutrients.

Therefore, it's important for individuals with lactose intolerance to follow appropriate nutrition plans and treatment strategies to manage their symptoms and maintain their quality of life. This typically includes avoiding milk and dairy products, turning to alternative nutritional sources, and taking appropriate supplements. It's also important to collaborate with a healthcare professional to manage this condition.