LACTOSE INTOLERENCE : “ Inability to digest milk”

Lactose : It is a disaccharide sugar ( also known as milk sugar) derived from glucose and galactose that is found in milk. It can be broken down into these monosaccharide ( glucose & galactose) by the use of enzyme lactase, which is produced in the digestive tract in humans. Once the lactose is broken down, it can be absorbed into the bloodstream for the small intestine.

Lactose intolerance : Lactose intolerance occurs when your small intestine doesn't produce enough of an enzyme (lactase) to digest milk sugar (lactose). People with lactose intolerance are unable to fully digest the sugar (lactose) in milk. As a result, they have diarrhea, gas and bloating after eating or drinking dairy products. The condition, which is also called lactose malabsorption, is usually harmless, but its symptoms can be uncomfortable.

Level : There are different degrees of lactose intolerance. For example, some people may be symptomatic after drinking1/2 cup of milk, while others may only get symptoms when they drink 1 cup. Other people may have difficulty drinking even less than 1/2 cup of milk. Over time, you will learn what quantity of milk and other dairy products your body can handle without having symptoms.

Cause : Normally, lactase turns milk sugar into two simple sugars — glucose and galactose — which are absorbed into the bloodstream through the intestinal lining. If you're lactase deficient, lactose in your food moves into the colon instead of being processed and absorbed. In the colon, normal bacteria interact with undigested lactose, causing the signs and symptoms of lactose intolerance. There are three types of lactose intolerance.

Different factors cause the lactase deficiency underlying each type.

1. Primary lactose intolerance

People who develop primary lactose intolerance — the most common type — start life producing enough lactase. Infants, who get all their nutrition from milk, need lactase. As children replace milk with other foods, the amount of lactase they produce normally drops, but usually remains high enough to digest the amount of dairy in a typical adult diet. In primary lactose intolerance, lactase production falls off sharply by adulthood, making milk products difficult to digest.

2. Secondary lactose intolerance

This form of lactose intolerance occurs when your small intestine decreases lactase production after an illness, injury or surgery involving your small intestine. Diseases associated with secondary lactose intolerance include intestinal infection, celiac disease, bacterial overgrowth and Crohn's disease. Treatment of the underlying disorder might restore lactase levels and improve signs and symptoms, though it can take time.

3.Congenital or developmental lactose intolerance

It's possible, but rare, for babies to be born with lactose intolerance caused by a lack of lactase. This disorder is passed from generation to generation in a pattern of inheritance called autosomal recessive, meaning that both the mother and the father must pass on the same gene variant for a child to be affected. Premature infants can also have lactose intolerance because of an insufficient lactase level.

Symptoms :

If not managed properly, lactose intolerance can cause severe digestive problem.

The most common symptoms are :

> Abdominal cramps

> Gas

> Diarrhea

> Bloating

> Some people also experience urgency to go to the toilet, nausea, vomiting, pain in the lower belly and occasionally constipation.

> Diarrhea occurs due to undigested lactose in your small intestine, which causes water to move into your digestive tract.

> Once it reaches your colon, the lactose is fermented by the bacteria in your gut, forming short chain fatty acids and gas. This causes the bloating, flatulence and pain.

Foods that contain lactose :

> Cow’s milk (all types)

> Goat’s milk

> Cheese (including hard and soft cheeses)

> Ice cream

> Yogurt

> Butter

Can you eat curd ( dahi) ?

If you're lactose intolerant, you can still eat foods with lactose -- in moderation. The key is to know your limit. Keep a food diary, write down when, what, and how much you ate, and how it made you feel. You should see a pattern emerge and you will learn how much or how little lactose you can have. Then, stick to your limit.

Look for curd with live and active bacterial cultures. When you eat this type of curd, the bacterial cultures can help break down the lactose. Plus just 1 cup of plain, low-fat curd provides 448 mg of calcium. But forget frozen curd. It doesn't contain enough live cultures, which means it may cause problems for people who are lactose intolerant. To be safe, you can always choose lactose-free curd.

Role of probiotics :

For some people, probiotics can ease symptoms of lactose intolerance. Probiotics are live microorganisms, usually bacteria, that restore the balance of "good" bacteria in your digestive system. They can be found in foods like yogurt or kefir -- probiotic-rich milk -- as well as dietary supplements. Check with your doctor to see if probiotics might help you.

Try to listen to your body :

As you experiment with eating dairy products, you'll figure out how much your digestive system can handle. Listen to your body and choose wisely. Want a slice of cheese pizza? Remember how you felt the last time you ate one. Were you bloated, uncomfortable, or crampy? If so, take a lactase supplement or have a sandwich or salad instead.

“When creating cow milk, Mother Nature was thinking about not only the nutritional needs but also the digestive capabilities of a calf, not those of a human being.”