Lactose intolerance

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Lactose intolerance

Lactose intolerance

Lactose, present in milk, is degraded by the lactase enzyme in the small intestine. The amount of this enzyme is at its peak at birth and gradually decreases with age; thus, the ability to degrade lactose also decreases. Undigested lactose is responsible for a wide range of digestive problems such as increase of free water content, rapid intestinal transit, and development of hydrogen. Lactose intolerance is in fact an evolutionarily archaic form because adult mammals do not have to digest lactose. Based on national data, approximately 35-40% of the Hungarian adult population is sensitive to lactose to some extent. However, a significant portion of the people can consume milk products throughout their life; members of northern European populations or of northwest areas of India still have a sufficient amount of lactase activity as adults. The reason of this is the presence of variants in two locations of the lactase gene, which influences the elimination of enzyme production. The significant variability between different populations can be accounted for by the different milk consumption habits. In people with lactose intolerance, typical symptoms develop following milk consumption (diarrhoea, stomach cramps and pains, flatulence, feeling sick), which cease or can be relieved by introducing a lactose-free diet.

We recommend testing lactose intolerance:

  • in babies; they may have congenital lactose intolerance, which inhibits the degradation of even breast milk. It is essential to distinguish lactose intolerance from milk protein sensitivity in order to select appropriate nutrition.
  • in those individuals who have digestive problems following milk or dairy product consumption.
  • in those individuals who have a lactose-intolerant family member (since lactose intolerance is genetically determined).
  • in those individuals who have digestive problems characteristic of lactose intolerance even without dairy product consumption. Hidden lactose present in processed food can cause problems in sensitive individuals.

Early diagnosis is important because:

  • besides causing unpleasant symptoms, lactose consumption continuously damages the absorptive surface of the small intestine
  • other nutrients cannot be absorbed either, leading to their deficiency.
  • in the long run, severe, irreversible diseases may develop (e.g. osteoporosis) due to the extensive damage in the absorptive surface of the small intestine.
  • lactose-degrading bacteria create an acidic environment, which is associated with malignant tumours of the large intestine.


How do I know, I have lactose intolerance?
There are several methods available to diagnose lactase enzyme insufficiency. The common ones include unpleasant lactose load tests, which are made in gastroenterology departments. More reliable and less unpleasant ones are the genetic tests which are working from simple blood or saliva samples. They can be done at any age and only once in a lifetime.
What should I do if I have lactose intolerance?
The most important is to keep a diet, which doesn’t necessarily mean to quit all kind of dairy product. Most of the lactose intolerance affected persons can tolerate small amounts of milk. It is beneficial to determine the level of personal lactose tolerance and set up the diet of lactose containing dairy products according to that. It is very important to include foods with higher calcium content like colewort, pulses or nuts, and take care about amount of necessary vitamin D.
What should I do to be tested?
You have to first schedule a meeting with our genetic counsellor, who will help you identify whether you or the members of your family need to be tested. If the test is needed, then a simple blood sample or a buccal swap is enough for us to isolate the necessary amount of DNA.
How long should I wait for the results?
Usually the results are ready in a week, after sample collection. The genetic counsellor will keep you updated, help in the interpretation of the results and inform you about your possibilities.