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."