Lactose intolerance is a common development in many Americans. Approximately 45 to 50 million Americans have lactose intolerance. Lactose intolerance is the result of a decreased production of lactase (the enzyme which degrades lactose in the small intestine). Acute infections of the GI tract may result in a transient lactase deficiency. In addition, certain populations are predisposed towards lactose intolerance. These include Mexican-Americans, Asian-American adults, American Indian adults, African Americans in the Jewish population.
Patients with lactase deficiency usually have some degree of lactase present in the small bowel. Thus, small amounts of lactose may be ingested without difficulty. Usually, ingestion of smaller amounts of lactose over a period is well tolerated. However, as the amount of lactase becomes larger, the lactase is overwhelmed resulting in diarrhea, belching, bloating and abdominal discomfort. These symptoms may occur within 10 to 15 minutes of ingestion of lactose. Less commonly, it may occur several hours later.
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