Intolerance to lactose-containing foods (primarily dairy products) is a common problem. The term lactose intolerance is applied to the development of characteristic symptoms after the ingestion of lactose:
- abdominal pain,
- bloating,
- flatulence,
- diarrhea,
- and, particularly in adolescents, vomiting.
The causes of lactose malabsorption can be divided into :
- primary lactase deficiency
- and lactase deficiency induced by underlying intestinal disease.
The term lactose malabsorption is generally reserved for those patients with typical symptoms in whom the intestinal malabsorption of lactose has been confirmed by a test of absorption (eg, lactose absorption test) or malabsorption (lactose breath hydrogen test).
The approach to patients with lactose malabsorption in the absence of a correctable underlying disease includes four general principles:
- Reduced dietary lactose intake.
- Substitution of alternative nutrient sources to maintain energy and protein intake.
- Administration of a commercially available enzyme substitute.
- Maintenance of calcium and vitamin D intake.