Lactose Intolerance and Symptoms Quiz

Lactose Intolerance

• Lactose intolerance occurs when the small intestine does not produce enough lactase enzyme, leading to mal-digestion of lactose (milk sugar).
• Undigested lactose reaches the colon, where intestinal bacteria digest it, producing glucose, galactose, and gas by-products.
• Symptoms include bloating, abdominal cramping, and diarrhea.
• Damage to the intestinal brush border of villi, where lactase is produced, can cause lactose intolerance, e.g., due to chemotherapy, radiation therapy, infection, celiac disease, or inflammatory bowel disease.
• Diet therapy involves avoiding dairy and dairy products, and obtaining sufficient calcium and vitamin D from non-dairy sources.
• Aged, cultured, and fermented dairy products, such as yogurt, aged cheeses, and buttermilk, may be tolerated due to lower lactose content and presence of good bacteria that produce lactase.

Diverticulosis and Diverticulitis

• Diverticulosis is characterized by the formation of little pockets or pouches called diverticula on the inside of the large intestine due to weakened muscle.
• Diverticulitis is the inflammation of the diverticula, caused by bacteria breeding in the pockets, leading to infection, pain, and inflammation.
• Diet therapy for diverticulosis involves a high fiber diet to increase stool volume, reduce pressure in the colon, and shorten transit time.
• Nuts, seeds, and popcorn may be temporarily avoided to prevent entrapment.
• For diverticulitis, treatment involves antibiotics, sometimes surgery, and a clear liquid diet, followed by a low-residue diet and then a high fiber diet when tolerated.

Constipation

• Constipation is characterized by infrequent or difficult stool passage.
• Causes include low fiber diet, medications, iron and calcium supplements, physical inactivity, and medical conditions such as Parkinson's, Spina Bifida, pregnancy, and neuromuscular diseases.
• Diet therapy involves a high fiber diet (20-35g/day) and adequate fluid intake.

Diarrhea

• Diarrhea is characterized by loose stool.
• Causes include certain diseases, infections, and medications.
• Diet therapy involves adequate liquid intake, avoidance of fatty foods, lactose, sugar alcohols, and caffeine, and introduction of starch CHO.
• BRAT diet (bananas, rice, applesauce, toast) and pre- and probiotics may be useful.
• Soups, broths, vegetable juices, and oral rehydration solution with electrolytes can also be helpful.

Inflammatory Bowel Diseases (IBDs)

• IBDs are chronic conditions causing inflammation in the GI tract, leading to malabsorption and malnutrition.
• Ulcerative Colitis is a type of IBD that affects the colon and rectum.
• Crohn's Disease is an autoimmune disease that affects both small and large intestines, causing ulcers, inflammation, and malnutrition.
• Symptoms include bloody diarrhea, cramps, fatigue, nausea, anorexia, and malnutrition, leading to weight loss.
• Diet therapy involves anti-inflammatory drugs, low-residue diet, adequate protein, calories, vitamins, and minerals, and total parenteral nutrition (TPN) in severe cases.

Irritable Bowel Syndrome (IBS)

• IBS is a condition characterized by unexplained abdominal discomfort or pain, associated with changes in bowel habits, gas, bloating, diarrhea, and constipation, and increased GI distress associated with psychosocial distress.
• Treatment options include medications focused on symptom relief and medical nutrition therapy.