Lactase enzyme deficiency

It is the absence in the intestine of the enzyme lactase, which is responsible for digesting lactose.

Lactose is the sugar in milk and its derivatives. To digest it, the body needs an enzyme called lactase, which transforms it into glucose and galactose.

When the enzyme lactase is not found in the intestine, lactose intake is a problem because it cannot be digested properly. Lactose intolerance is not an allergy, it is a disease of the gut

It is not a common disease in babies or children.

Sucrase-isomaltase deficiency

It is the absence of the enzymes sucrase and isomaltase. These are responsible for digesting the carbohydrates sucrose and isomaltose. Symptoms are similar to lactase deficiency: watery diarrhea, abdominal pain and bloating. The treatment is to avoid the intake of these sugars. This deficit is usually transient and improves sucrose and isomalt tolerance over time.

Enterokinase deficiency

There is a shortage of the enzyme enterokinase, which is responsible for the digestion of proteins. Its deficit causes diarrhea and poor protein absorption; This situation can trigger a hypoprotein malnutrition in the child with weight loss, low proteins in the blood and edema.

Causes

It can be of congenital cause, in which lactase is missing from birth (it is a very rare situation), or it can be an acquired deficit. In these cases there is a progressive decrease in lactase in the intestinal mucosa cells after two or three years without the cause being known. The acquired deficit can be partial or total.

Symptoms

Symptoms can vary from one person to another, but the most common are abdominal pain, explosive watery diarrhea and swelling of the abdomen after eating foods rich in lactose: milk and derivatives.

Symptoms usually appear between 30 minutes and 2 hours after ingestion and disappear completely between 3 and 6 hours.

This is due to the fact that lactose, which has not been digested in the small intestine, passes to the colon (large intestine) and there the bacteria of the intestinal flora ferment it and produce gases.

Treatment

Treatment, once diagnosed by the Pediatrician, is to avoid lactose. There are special milk without this sugar that can be offered to the baby. In the case of a partial deficit, some children tolerate dairy products (yogurt or cheese) because they have a lower amount of lactose than milk.

Transient lactase deficiency

In cases of prolonged diarrhea (greater than 14 days), the mucosa of the intestine can be severely damaged and the child may have a lactase deficiency. This will cause lactose intolerance but it will be for a limited time, until the intestinal mucosa and flora fully recover.

The treatment in these cases is the same: avoid milk and its derivatives until the intestine has fully recovered.