Lactose intolerance is the inability to completely digest lactose (the main sugar in milk, dairy, and milk products) while the food is passing through the small bowel. In people who can tolerate lactose, all lactose molecules are broken down to glucose and galactose inside the small bowel.

Lactose intolerance is usually the result of your body not producing enough lactase enzymes in the small bowel. Lactase is an enzyme (a protein that causes a chemical reaction to occur) normally produced in your small intestine that's used to digest lactose. If you have a lactase deficiency, it means your body does not produce enough lactase.

Primary lactose intolerance is due to low levels of lactase enzyme, which develop after childhood.

Secondary lactose intolerance is an acquired, lactase deficiency that may develop in a person with a healthy small intestine during episodes of acute or chronic illness such as small bowel inflammation. This occurs because of mucosal damage or from medications. 

Congenital lactose intolerance is inherited as an autosomal recessive trait and is very rare.

Experts estimate that about 70% percent of the world's population is lactose-deficient. While most infants can digest lactose, many people begin to develop lactose malabsorption after infancy. 

When lactase enzymes are absent or deficient, non-absorbed lactose molecules enter the colon where they are fermented, leading to the excessive production of short-chain fatty acids and gases such as hydrogen, methane, and hydrogen sulfide.

This in turn can lead to abdominal bloating, distension, gaseous, cramping, pain, excessive flatulence, and osmotic diarrhea.

·     The hydrogen breath test is the diagnostic test of choice. Subjects are administered lactose solution after an overnight fast, after which expired air samples are collected before and at 30-minute intervals for 3 hours to assess hydrogen gas concentrations.

·     The hydrogen-methane breath test is based on the premise that when patients fail to digest lactose in the small intestine, non-absorbed carbohydrates will reach the colon where lactose is fermented by the intestinal flora producing hydrogen and/or methane that diffuse into the circulation and are ultimately expired in the breath.

·     We offer you this breath test in Burjeel Hospital in Abu Dhabi.

·     You can contact us for an appointment (mobile no. 056-329 9935).

The best treatment of lactose intolerance is a combination of dietary modification to avoid lactose containing foods, and if eating foods with lactose taking a supplement to aid in digestion of lactose. 

When an individual intends to eat food that contains lactose they should take a commercially available non-prescription lactase supplement at the time of lactose ingestion. This type of supplement can be taken throughout the day whenever lactose is ingested. Some individuals will be less lactose intolerant and therefore will be able to tolerate comparatively larger amounts of lactose. Alternatives to milk for lactose intolerant individuals include  plant based products such as soy milk, Almond milk, coconut milk and others. If an individual is restricting their lactose intake it is important to ensure adequate supplementation of calcium and Vitamin D in the diet.