Lactose intolerance causes diarrhea

Lactose intolerance causes diarrhea

By Tony Smith

JAKARTA (JP): "Many cases of diarrhea in young children may
not be caused by bacterial infection due to insanitary
conditions, but because of intolerance to the carbohydrate
lactose found in milk," says leading international pediatrician
Dr. Hans Alexander Buller.

Lactose is a carbohydrate found exclusively in milk and
accounts for 100 percent of its raw energy content. It cannot be
used by the body in its original form and can only be digested
effectively with lactase, which is produced in the small
intestine. Lactase is an enzyme that enables the body to break
down the lactose in milk into substances which can be absorbed
and used by the body. Most children up to the age of five years
are able to digest large amounts of lactose because their bodies
produce sufficient amounts of the enzyme lactase.

All forms of lactose intolerance are caused by a deficiency of
the enzyme lactase, but the reasons for lactase deficiency vary
greatly.

"Primary lactase deficiency," says Buller, "occurs in
premature children and is a result of immature intestinal
development, or in rare cases because the child is born without
the gene which is responsible for producing lactase."

" Secondary lactase deficiency usually occurs after a bout of
diarrhea, which causes injury to the intestinal mucosa which
produce the lactase. This inability to digest lactose often
results in more diarrhea, with abdominal pain, cramps, swelling
and flatulence. It can be distinguished because the stools it
produces are often watery, bulky and frothy," he added.

Although diarrhea can cause temporary lactase deficiency,
Buller's research shows that only a minority of children need to
switch to low lactose, or milk free, diets because after the
initial diarrhea has been stabilized the intestine usually
recovers quickly.

"If your child has been able to consume milk easily before
they get diarrhea, but then as a result of the diarrhea they
develop a problem, it's better not to try to change their diet.
As long as they are no longer dehydrating, you should carry on
feeding them normally, complete with milk. In cases of persistent
diarrhea though, it's better to switch to low lactose milk
formulas rather than withdrawing milk altogether, or diluting
normal milk with water."

It is rarely necessary, nor desirable, to resort to a milk
free diet for young children because milk is the perfect food for
growing bodies, containing all the vitamins, minerals and
nutrients necessary for healthy physical development.

"You should always consult a doctor before stopping the milk
in a child's diet," says Buller, "and the decision should only be
made after extensive tests."

Buller's current research is focusing on using "friendly"
bacteria as a treatment for these cases of persistent diarrhea.
He has found that the bacteria lactobacillus found in yogurt can
often help in these cases.

"The bacteria present in 'live' yogurt, are able to digest
lactose, so adding yogurt to the infant's normal diet can assist
in these situations," he explained.

The "friendly" bacteria does the job of the missing lactase
enzyme until the intestinal mucosa recover and begin to produce
sufficient quantities of the enzyme to start independently
digesting lactose once again.

Buller was born in Surabaya in 1952, and chose to study
pediatric medicine because he "was interested in the health
problems of children." He recently toured Indonesia, lecturing
members of the Indonesian Pediatricians Association. The tour was
sponsored by baby food company Nutricia. Buller currently works
at the Academic Medical Center, University of Amsterdam. He has
been studying lactose since 1984 and believes that, "given the
better economic conditions in Indonesia, it is high time to give
more concern over child growth and health."