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All about malabsorption syndrome causes of malabsorption symptoms of malabsorption diagnosis of malabsorption treatment for malabsorption celiac disease gluten causes of celiac disease symptoms of celiac disease celiac disease diagnosis treatments for celiac disease celiac disease and gluten-free diet lactose intolerance causes of lactose intolerance symptoms of lactose intolerance diagnosis of lactose intolerance treatment of lactose intolerance lactose-free diet Whipple's disease causes of Whipple's disease symptoms of Whipple's disease diagnosis of Whipple's disease treatment for Whipple's disease

What causes lactose intolerance?

Lactose is a disaccharide, which means that it is composed of two other sugars bound together. In order for lactose to be absorbed, it must be split into those two smaller sugars. This split is performed by an enzyme called lactase, which is present in the lining of the small intestine. If the levels of the lactase enzyme are low or absent, then that splitting does not

occur. The lactose is fermented by the bacteria in the large intestine and this produces excess gas and stomach rumbling and leads to diarrhoea.

The normal mammalian condition is for the young to lose the ability to effectively digest milk sugar (lactose) at the end of the weaning period (a species-specific length of time usually equal to roughly 3% of lifespan). It has been established that certain human populations have undergone a mutation on chromosome 2 which results in a bypass of the normal shutdown in lactase production, allowing members of these groups to continue consumption of fresh milk and fresh milk products throughout their lives.

Without lactase, the lactose in milk remains uncleaved and unabsorbed, and instead gut bacteria metabolise it, producing copious amounts of gas by fermentation. This causes a range of unpleasant abdominal symptoms, including stomach cramps, flatulence and diarrhea. Like other unabsorbed sugars, e.g. mannitol, the lactose raises the osmotic pressure of the colon contents, preventing the colon from resorbing water and hence causing a laxative effect to add to the excessive gas production. Lactase activity is high in babies and declines as the amount of milk in the diet decreases. Some people may have very low lactase levels but not have any symptoms.

There are two ways by which lactose intolerance can be acquired. Primary lactase deficiency/non-persistence is a genetically inherited, age-related decrease in lactase activity, which normally becomes apparent between the ages of 5-20 years. It is not a condition of early childhood. The loss of lactase activity is rarely total, but decreases to 10-30% of the initial level of the enzyme activity. In primary lactase deficiency, the decrease in enzyme activity is permanent and cannot be induced by large quantities of lactose (by lactose ingestion). Secondary lactase deficiency is a transient state of lactase deficiency due to damage to the lining of the intestine where the lactase is produced. This damage can be caused by a severe bout of gastroenteritis, malnutrition, uncontrolled coeliac disease, inflammatory bowel disease, cancer or toxins. Although lactose intolerance is mainly present in the adult population, temporary secondary lactose intolerance can occur in babies and young children following gastroenteritis or other forms of infection affecting the intestinal tract. The symptoms of secondary lactose intolerance normally disappear when the intestinal wall has recovered from the injury, normally within 2-4 weeks.

More information on malabsorption (celiac disease, lactose intolerance, Whipple's disease)

What is malabsorption? - Malabsorption is the inability to absorb nutrients through the gut lining into the bloodstream. Malabsorption is the failure of the GI tract to absorb one or more substances from the diet.
What causes malabsorption? - The causes of malabsorption include cystic fibrosis, lactose intolerance, celiac disease, Whipple disease, acrodermatitis enteropathica, biliary atresia, pernicious anemia.
What are the symptoms of malabsorption? - The signs and symptoms of malabsorption may include failure to thrive, diarrhea, cramping, frequent bulky stools, bloating, flatulence, and abdominal distention.
How is malabsorption diagnosed? - The diagnosis of malabsorption syndrome and identification of the underlying cause can require extensive diagnostic testing.
What's the treatment for malabsorption? - Treatment of malabsorption is the treatment of the causing disease. Fluid and nutrient monitoring and replacement is essential for individual with malabsorption syndrome.
What is celiac disease? - Celiac disease is a sensitivity to gluten, a wheat protein. Individuals with this disease must avoid gluten-containing grains, which include all forms of wheat, oats, barley, and rye.
What is gluten? - Gluten is a protein in grains such as wheat, oats, rye, and barley. Gluten is responsible for the elasticity of kneaded dough which allows it to be leavened.
What causes celiac disease? - The exact cause of celiac disease is not known. The principal cause of the disorder is an immunologic reaction to components of certain dietary glutens.
What are the symptoms of celiac disease? - The symptoms of celiac disease (CD) vary so widely among patients that there is no such thing as a typical celiac. Symptoms may or may not occur in the digestive system.
How is celiac disease diagnosed? - Celiac disease may be diagnosed by observing the symptoms after an infant begins eating cereals. The diagnosis is suspected when a person has the above-mentioned symptoms.
What are the treatments for celiac disease? - Many of the effects of celiac disease can be treated and minimized with a special diet. People with celiac disease learn to avoid the proteins in cereal.
Celiac disease and gluten-free diet - A gluten-free diet is a diet completely free of ingredients derived from gluten containing cereals, wheat, oats, barley and rye.
What is lactose intolerance? - Lactose intolerance is a set of symptoms resulting from the body's inability to digest the milk sugar called lactose. Lactose is sugar occuring naturally in milk and is also called milk sugar.
What causes lactose intolerance? - Primary lactase deficiency is a genetically inherited. Secondary lactase deficiency is a transient state of lactase deficiency due to damage to the lining of the intestine.
What are the symptoms of lactose intolerance? - People with lactose intolerance usually cannot tolerate milk and other dairy products. The symptoms of lactose intolerance are dose-dependent.
How is lactose intolerance diagnosed? - Lactose intolerance is widely regarded as a medical condition. The most common test for lactose intolerance is the hydrogen breath test.
What's the treatment for lactose intolerance? - Lactose intolerance can be controlled and treated through diet by avoiding foods containing lactose, primarily dairy products.
Manage lactose intolerance with lactose-free diet - People who are very sensitive to lactose should be aware that lactose is widely used as an ingredient in many ready-made meals and other food products.
What is Whipple's disease? - Whipple's disease is a malabsorption disease. It interferes with the body's ability to absorb certain nutrients.
What causes Whipple's disease? - Whipple's disease is caused by the organism Tropheryma whippelii. The disease causes lesions on the wall of the small intestine and thickening of the tissue.
What are the symptoms of Whipple's disease? - Whipple's disease causes weight loss, irregular breakdown of carbohydrates and fats, resistance to insulin, and malfunctions of the immune system.
How is Whipple's disease diagnosed? - Whipple's disease is diagnosed through a tissue sample (biopsy) of the small intestine, or of an enlarged lymph node.
What is the treatment for Whipple's disease? - Whipple's disease is treated with antibiotics to destroy the bacteria that cause the disease, treatment may also include fluid and electrolyte replacement. 
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