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LACTOSE INTOLERANCE(Milk Intolerance; Lactase Deficiency)

LACTOSE INTOLERANCE
(Milk Intolerance; Lactase Deficiency)

DESCRIPTION

Lactose intolerance is a disorder characterized by difficulty in digesting cow's milk. Lactose intolerance occurs--with varying severity -- in 75% of the black population, 90% of Orientals and American Indians, and less than 20% of Caucasians of northwest European origin. It is not contagious or cancerous. The digestive system is involved.
Appropriate health care includes:
  • Self-care after diagnosis, including dietary adjustments.
  • Physician's monitoring of general condition and medications.

    SIGNS & SYMPTOMS
    In infants and children:

  • Foamy diarrhea with diaper rash.
  • Vomiting.
  • Slow weight gain, growth, and development. In adolescents and adults:
  • Rumbling abdominal sounds, abdominal cramps, and diarrhea.
  • Gas and bloating.
  • Nausea.

    CAUSES

  • Deficiency or absence of the enzyme lactase. Lactase is necessary to digest all milk except mother's milk. Without it, sugars in milk absorb fluid and cause diarrhea. Although some infants are born with the disorder, lactose intolerance usually develops in adulthood.
  • Temporary lactose intolerance can occur in an infant after a severe bout of gastroenteritis that damages the intestinal lining.

    RISK FACTORS
    Family history of enzyme-lactase deficiency.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Cannot be prevented at present. If you are pregnant and there is a history of lactose intolerance in your family, consider breast-feeding your baby. If not, you may need an alternate non-milk formula for your infant.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory studies, such as a stool exam and lactose-tolerance test.
  • X-rays of the child's lower intestinal tract.
  • Therapeutic trial with a milk-free diet.

    POSSIBLE COMPLICATIONS

    Infants with an inherited deficiency will not thrive without treatment.

    PROBABLE OUTCOME
    This condition is currently considered incurable. However, your child's symptoms can be relieved or controlled with a diet free of milk and milk products. Symptoms worsen at times for unexplained reasons.

    TREATMENT

    HOME CARE

    No special instructions except those listed under other headings.

    MEDICATION

  • Your doctor may prescribe a supplement for your child to neutralize lactose in milk.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS

  • If the condition is present at birth, your doctor will probably prescribe an infant formula that contains little or no lactose, such as a soybean-based formula.
  • If the lactose intolerance is temporary and caused by gastroenteritis, the substitute formula should be necessary for a short time only. Cow's milk can be introduced again later.
  • Older children and adolescents with lactose intolerance should avoid milk and milk products, such as cheese and ice cream.

    OK TO GO TO SCHOOL?

    Yes. This is not contagious.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of lactose intolerance.
  • Your child's temperature rises to 101F (38.3C) or higher.
  • Your infant fails to gain weight.
  • Your infant refuses food or formula.
  • Vomiting or diarrhea reappears in a child who has previously had a temporary intolerance to milk or milk products.
  • A milk-free diet doesn't relieve your child's symptoms. ‡
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