Lactose intolerance.

Area of Science:

• Nutritional Science
• Pediatric Gastroenterology

Background:

• Lactose is a primary carbohydrate in infant nutrition, decreasing in importance with age.
• Congenital lactose intolerance is rare; however, infants may have immature lactase activity.
• The link between unabsorbed lactose and infantile colic is debated, with potential benefits like improved calcium absorption.

Purpose of the Study:

• To review the understanding of lactose intolerance in infants and children.
• To differentiate between congenital and secondary lactose malabsorption.
• To clarify diagnostic approaches and management strategies for lactose intolerance.

Main Methods:

• Review of existing literature on lactose metabolism and intolerance.
• Analysis of evidence linking lactose malabsorption to infantile symptoms.
• Description of diagnostic methods, including clinical assessment and lactose breath tests.

Main Results:

• Unabsorbed lactose can have positive effects, such as a bifidogenic impact and enhanced calcium absorption.
• Secondary lactose malabsorption, often following gastroenteritis or allergies, is reversible upon treating the underlying cause.
• Late-onset lactase deficiency is common in Asian populations but rarely symptomatic before age 4-5.

Conclusions:

• Lactose intolerance symptoms include cramps, flatulence, and watery stools, impacting quality of life but not indicating serious disease.
• Diagnosis relies on clinical presentation, potentially confirmed by lactose breath tests.
• Lifelong dietary modification, reducing lactose intake, is key for managing symptoms and improving quality of life.