What is the difference between lactose intolerance and lactose intolerance be specific

A food allergy can be potentially life-threatening. Unlike food allergies, food intolerances do not involve the immune system. People who are lactose intolerant are missing the enzyme lactase. Lactase breaks down lactose, a sugar found in milk and dairy products. As a result, people with lactose intolerance are unable to digest these foods. They may experience symptoms such as nausea, cramps, gas, bloating and diarrhea. While lactose intolerance can cause great discomfort, it is not life-threatening.

About 2. Nearly all infants who develop an allergy to milk do so in their first year of life. Join us Oct. These may include: Lactose tolerance test. This test checks how your digestive system absorbs lactose. You will be asked not to eat or drink anything for about 8 hours before the test. This often means not eating after midnight. For the test, you will drink a liquid that contains lactose. Some blood samples will be taken over a 2-hour period.

These will check your blood sugar blood glucose level. Hydrogen breath test. You will drink a liquid containing a lot of lactose. Your breath will be checked several times. High levels of hydrogen in your breath may mean you are lactose intolerant. Stool acidity test. This test is used for infants and young children. It checks how much acid is in the stool. If someone is not digesting lactose, their stool will have lactic acid, glucose, and other fatty acids.

Foods to Avoid if You Have IBS While lactose intolerance and irritable bowel syndrome IBS are two different conditions, both can cause similar symptoms for people who drink milk or eat milk products.

Read More. How is lactose intolerance treated? Here are some tips for managing lactose in your diet: Start slowly. Try adding small amounts of milk or milk products and see how your body reacts. Have milk and milk products with other foods. You may find you have fewer symptoms if you take milk or milk products with your meals.

Try eating cheese with crackers or having milk with cereal. Eat dairy products with naturally lower levels of lactose. These include hard cheeses and yogurt. Look for lactose-free and lactose-reduced milk and milk products. These can be found at many food stores. They are the same as regular milk and milk products, but they have the lactase enzyme added to them. Casein haplotypes and their associations with milk production traits in Norwegian Red cattle.

Genetics, Selection, Evolution. A similar result was obtained by Olenski et al. Polymorphism of the beta-casein gene and its association with breeding value for production traits of Holstein-Frisian bulls. Livestock Science, 1 , Therefore, on top of adding value to human health, A2 allele beta-casein may be associated with higher production of milk and protein in cattle.

New Zealand currently has dairy farms producing only milk with A2 protein called A2 milk , due to assumptions that this variant is not harmful to human health, as opposed to variant A1 Vercesi, This fact led researchers to study all breeds and discover which produced larger amounts of A1 and A2 milk Garcia, Garcia, J.

O leite A. In addition to the known characteristics of rusticity and external parasite resistance, there is now another advantage; Gyr milk is non-allergenic Garcia, Garcia, J. In a study conducted by Lima Lima, T. Lactose intolerance is intolerance to the most common carbohydrate in milk affecting all age groups Matthews et al. Systemic lactose intolerance: a new perspective on an old problem.

Postgraduate Medical Journal, 81 , It could be described as an intestinal mucosa disorder that incapacitates the digestion of lactose due to the deficiency of an enzyme called lactase Heyman, Heyman, M. Lactose Intolerance in Infants, Children and Adolescents. Milk consumption and lactose intolerance in adults. Biomedical and Environmental Sciences, 24 5 , This is a generic term that refers to the varied clinical manifestations caused by adverse reactions triggered by food.

This compound belongs to the group of carbohydrates included in the group of sugars classified as a disaccharide. Lactose is present in several types of milk, and all mammals, including humans, when born under normal conditions are able to digest this sugar. Lactose intolerance. American Family Physician, 65 9 , According to Jellema et al. Lactose malabsorption and intolerance: a systematic review on the diagnostic value of gastrointestinal symptoms and self-reported milk intolerance.

QJM, 8 , Ethnic groups such as blacks, Hispanics and Asians are more likely to develop this intolerance Swallow et al. Intolerance to lactose and other dietary sugars. Approach to the patient with diarrhea and malabsorption. Ausiello Eds. Philadelphia: Saunders. Most newborns have lactase when they are born and can digest lactose as infants. If an infection or food allergy affects the small intestine, the child can develop lactose intolerance, causing a reduction in lactase.

Usually this damage is temporary, but it can take weeks or even months until the child can tolerate milk and dairy products again. Children naturally start to produce less lactase at ages than in the first two years of life.

In some children the production continues to decline, or may cease altogether. Symptoms of lactose intolerance often appear in adolescence or early adulthood Swallow et al. Lactose, commonly known as milk sugar, is a disaccharide composed of glucose and galactose formed by the mammary glands of mammals through glucose to supply the carbohydrate component during lactation, and is the same found in cow's milk, human breast milk and all other mammals Lomer et al. Review article: lactose intolerance in clinical practice - myths and realities.

Galactose is enzymatically converted into glucose, which is the main metabolic fuel of many tissues. The lactase activity is high during the neonatal period, but it declines during weaning Matthews et al. When lactose reaches the intestinal lumen, it must be hydrolyzed into monosaccharides by lactase, which is an endo-enzyme present in the brush border membrane of the intestinal mucosa epithelial cells of the intestinal lining Heyman, Heyman, M.

Intestinal disaccharides are synthesized by polysomes of the rough endoplasmic reticulum of enterocytes. They migrate to the Golgi apparatus where glycosylation is completed. Then they are transported in Golgi vesicles to the top of the membrane of mature enterocytes of small intestine villi, where they are attached and become more vulnerable to attacks than other disaccharides. Revista de Gastroenterologia del Peru, 21 4 , The products of the lactase enzyme on lactose glucose and galactose are absorbed by the mucosa of the small intestine.

A small amount of carbohydrates may not be digested by enzymes and reach the colon intact, thereby suffering fermentation by local bacterial flora, and with the production of short chain fatty acids butyric acid, propionic acid, acetic acid , and gases CO 2 and H 2.

The products of carbohydrate bacterial fermentation are absorbed in the colon and the calories are used up, thus contributing to the maintenance of the energy balance.

Under normal conditions, lactase is present in distal cells of the intestinal mucosa villi to perform lactose digestion. In deficiencies when disaccharidase activity is low, the events in the colon are accentuated by a higher rescuing of products that could have toxic effects to the organism and increased production of short chain fatty acid SCFA , H 2 and CO 2 , which play an important role in clinical manifestations rashes, flatulence, bloating and abdominal pain , since they cause intestinal distension.

The undigested lactose increases the osmotic load in the digestive tract, which adds to the clinical symptoms of lactose intolerance. The lactic acid produced by the microorganisms is osmotically active and pull water as well as undigested lactose, into the intestines resulting in diarrhea Matthews et al.

The presence of osmotically higher content than intestinal lumen mucosal cells osmolarity determines the passage of water and, to a lesser extent of electrolytes of these cells to the enteral light in order to equalize osmotic pressure.

Thus, large amounts of carbohydrates, whether digested or not, retain large amounts of water when they are not absorbed into the intestinal lumen in attempting isotonicity. When the amount of electrolytes lost is lower than the water, evacuations tend to be liquid Swagerty et al. The absorption of glucose and galactose is done at different speeds. The determining factor for maximum speed of lactose absorption depends on the amount of lactase present in the intestinal mucosa.

Monosaccharides go through the mucosa and are actively transported into the bloodstream. Both glucose and galactose depend on sodium to be transported. When they are in the bloodstream, they travel through the portal vein to the liver where they are metabolized Guerra, Guerra, S. Although lactase levels are normal in infancy, in adulthood these individuals start to present low levels of this enzyme.

This decrease of quantity and the intestinal lactase activity is determined by genetic factors. However, it also is influenced by environmental factors such as the presence of malnutrition, parasites, intestinal infections and alcoholism.

Moreover, in some cases it may represent an adaptive response to the decrease of dairy product intake Guerra, Guerra, S. Signs and symptoms of lactose intolerance are similar to any other specific enzyme deficiency. They include abdominal pain, bloating in the abdomen, flatulence, diarrhea, intestinal noises, and particularly in the young, vomiting. Abdominal pain may be crampy and is often located in the periumbilical region or lower quadrant. The intestinal noises may be heard during the physical examination and by the patient.

The stools are usually bulky, frothy and watery. An important feature is that these individuals usually do not lose weight, even with chronic diarrhea mentioned above.

In some cases, gastrointestinal motility is reduced and the subjects may have constipation, possibly as a result of methane production Guerra, Guerra, S. Even when only lactose absorption is directly damaged by lactase deficiency, the resulting diarrhea can be intense enough to remove other nutrients before they can be absorbed and may cause malnutrition, especially in children.

Lactose intolerance is also responsible for many systemic symptoms, such as headaches and dizziness, loss of concentration, short term memory difficulty, muscle and joint pain, severe tiredness, various allergies, cardiac arrhythmia, oral ulcers, sore throat and increased frequency of urination.

There is a wide variability of symptoms among patients with lactose intolerance. Generally, foods with a high fat content and osmolality decrease gastric emptying and reduce the severity of symptoms induced by lactose Jellema et al. Depending on the intensity of lactose intolerance, net losses from diarrhea can be very large and result in major loss of electrolytes, particularly sodium and potassium, as well as dehydration.

Hyponatremia may be aggravated by inadequate replacement at the expense of poor liquids or being exempt of sodium. However, in osmotic diarrhea, the fluid losses are greater than sodium, as other molecules draw water into the intestinal lumen.

Thus, hypernatremia occurs which increases when the replacement is also incorrect, providing excess sodium with respect to water. Hypernatremic dehydration is found in children, especially under 2 years of age and may endanger the life of the patient when treatment is not done with balanced solutions Jellema et al. Clinical manifestations of milk protein allergy related to the digestive tract are very similar to those of lactose intolerance, which can easily lead to misdiagnosis.

However, CMPA can cause skin lesions atopic eczema and also respiratory symptoms, which does not occur in lactose intolerance. Lactose intolerance, in turn, is purely a matter of digestion and absorption, with no immunologic mechanism involved in the pathophysiology, and it affects adults more frequently than children. The difference of the characteristics between these two pathologies is described in Table 4.

Even with so much information available, many people still have difficulties in identifying the differences between lactose intolerance and allergy to milk protein. These doubts do not occur only with patients; many health professionals have trouble with concluding the diagnosis, generating nutritional complications in patients.

CMPA is totally linked to immune responses, since it is the defense to a protein not recognized by the body; lactose intolerance is a metabolic disorder caused by an absence of lactase, and thus has the characteristic of not being able to absorb the sugar present in cow's milk.

These conditions are similar in some points, such as in the symptoms, as both have gastrointestinal reactions. However, with the allergy there can be no intake of the milk protein, as its consumption is only recommended after treatment. In LI, deprivation occurs also from milk, but some people can consume some types of dairy products, as long as lactose has been previously hydrolyzed.

However, independent of the condition, there can be no diagnostic errors as there will be implications on the nutritional, physical and psychological state of the patient. Because of this, it is essential that professionals know how to recognize the most appropriate way possible to not submit the patient to greater losses exacerbating the responses to the aggressor.

So professional nutritionists need to analyze and adapt to the nutrient intake, optimizing the availability of macro and micronutrients necessary for the maintenance and good health.

Abrir menu Brasil. Food Science and Technology. Abrir menu. Abstract Adverse reactions to food intake have very diverse etiology and symptomatology. Table 1 Composition of the main proteins in breast milk and cow's milk. Table 2 Sensitization percentage of protein fractions. Table 3 Primary adult hypolactasia prevalence in different populations. Table 4 Differentiating characteristics between lactose intolerance and cow's milk protein allergy.

Practical Application: Know and differentiate lactose intolerance and allergy to cow's milk protein. References Bahna, S. Bailey, R. Benhamou, A. Carvalho-Junior, F.