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Lactose Intolerance in the Elderly

Digestive problems are common in seniors, sometimes associated with age-related changes while at other times due to diseases, drugs or surgery. A person who may otherwise have tolerated milk sugar (lactose) may find that their ability to process dairy products changes as they get older. With milk sugar, this is known as lactose intolerance. It is one of the most common of the food intolerances.

What is lactose intolerance?

Lactose intolerance is the partial or complete inability to digest lactose. Normally lactose is digested by an enzyme called lactase but a deficiency of lactase causes lactose intolerance. Though this is not a life threatening condition, it can lead to severe discomfort and affect a person’s quality of life.

Signs and Symptoms

Symptoms of lactose intolerance can vary. Some people can consume dairy products to a certain extent and symptoms are seen only on excess consumption whereas in other cases consumption of even small amounts of milk products leads to severe symptoms. This includes :

  • Abdominal bloating
  • Gas builds up (flatulence)
  • Abdominal cramps
  • Diarrhea
  • Nausea

Causes and Triggers

Lactose intolerance is caused when sufficient amount of the enzyme lactase is not produced by the small intestine. This enzyme is required to digest the lactose, which can then be absorbed by the body. When undigested lactose reaches the large intestine, it causes the above mentioned symptoms as it draws fluid into the bowels and upsets the growth of the naturally occurring colonic bacteria.

During childhood, when milk is a major source of nutrition, large quantities of lactase are produced in the body. This decreases after childhood as a result of a genetic program, as the body relied on a varied source of nutrition. It can occur in people of any age but is more common in people of certain races such as Asians, Africans and not that common among Europeans.

This can also be caused by :

  • bowel surgery
  • bacterial or viral infection in the intestine which can damage the intestinal lining
  • intestinal disease such as celiac sprue or cystic fibrosis
  • genetic predisposition and hereditary factors

Treatment and Diet

Although lactose intolerance is incurable, a person suffering with the condition can prevent the symptoms by avoiding milk or dairy products. Most people with low levels of lactase can consume up to 2 to 4 ounces of milk but larger servings will cause problems.

  • Fermented milk products such as yogurt or b uttermilk is tolerated by some people.
  • Milk with reduced lactose is also available in the market.
  • Lactase treated milk can be consumed by both children and adults.
  • Lactase enzyme can be added to regular milk or consumed in a tablet form.
  • Soy milk and its products can be consumed by people with lactose intolerance.

Milk and meat are the major source of calcium in the body. The biggest concern for lactose intolerant people is to make sure that there is enough calcium in the diet. This can further lead to a shortage of riboflavin, vitamin D and proteins in the diet, especially in people on a vegetarian diet. Daily requirement of the calcium is 1200 to 1500 mg. Therefore to meet these requirements, calcium supplements or foods rich in calcium such as green leafy vegetable, broccoli, orange juice with added calcium, almonds and other milk substitutes discussed before should be included in the diet.


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