Mainguet, Paul
[UCL]
Primary acquired lactose deficiency, as a result of a decline of the enzyme activity, is the more common cause of lactose intolerance in adults and is often misdiagnosed. The loss of the enzymatic activity is definitive and is due to an isolated, acquired deficit in lactase in the absence of structural alteration of enterocytes. The deficiency may be secondary and reversible in case of damage in enterocyte brush border due to multiple conditions. In developing and tropical countries, both primary and secondary lactase deficiency may be associated thus making the diagnosis more difficult. In the majority of the malabsorbers, primary lactase deficiency is asymptomatic. Osmotic diarrhea is the striking symptom. In the case of lighter abdominal complaints, an overlap with irritable bowel syndrome has been described. Alimentary inquiries in malabsorbers are especially difficult in Western countries and must take into account lactose intake linked to the consumption of powered milk added to commercial foods. The H2 breath test remains the most useful and less expensive method of diagnosis despite its lower sensitivity as compared with the 13C lactose breath test which provides a better indication but is not commonly available. The goals of treatment are the relief of symptoms and the prevention of osteoporosis resulting partially from lifelong low calcium consumption. Treatment requires a low lactose diet with high intake of calcium and the use of a fungic lactase before the meals or added to the milk before consumption.
Bibliographic reference |
Mainguet, Paul. L'intolerance au lactose de l'adulte problemes nutritionnels et therapeutiques. In: Acta Endoscopica, Vol. 30, no. 3, p. 211-222 (2000) |
Permanent URL |
http://hdl.handle.net/2078.1/164722 |