Lactose Intolerance and Celiac Disease

Lactose intolerance is not the same as an allergy to milk. Lactose intolerance differs from a milk allergy in that a milk allergy is an immune system reaction and true lactose intolerance is due to a deficiency of the enzyme lactase that digests the milk sugar lactose that does not cause an immune system reaction. Lack of this enzyme can cause some disturbing symptoms including but not limited to bloating, gas and diarrhea.

It is estimated that 68% of the world’s population have lactose intolerance, which is also referred to as lactose malabsorption. The 68% of the population with lactose intolerance also has a majority demographic in Africa and Asia, while in northern Europe, some people carry a gene where the C allele indicates lactase nonpersistence (they do not produce the enzyme lactase) and the T allele indicates lactase persistence (they do produce the enzyme lactase).

In the general US population high risk groups include: African Americans, Indigenous peoples of the Americas, Asian Americans, Hispanics/Latinos.

Doctors use a hydrogen breath test to make a diagnosis because typically there is a small amount of hydrogen (a gas) in our breath, but if you suffer from lactose intolerance and cannot digest the milk sugar lactose, hydrogen levels become very elevated and it is easy to capture with this test. The test itself is not fun for the lactose intolerant individual. You drink a liquid that contains a set quantity of lactose and every 30 minutes over a few hours you must breathe into a balloon type container that calculates the amount of hydrogen in your breath. Additionally, your symptoms will be monitored. The combination of increased hydrogen and symptoms results in a diagnosis.

There also is data indicating that a simple genetic test is as sensitive and specific as an H2 test, without the side effects for those who are positive on the breath test. The gene MCM6 rs4988235 is associated with the risk of lactose intolerance. A CC allele is strong evidence of lactose intolerance.

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