Lactose insufficiency test for infants
If the child is intolerantmilk food, doctors prescribe an analysis for lactose deficiency. Such pathology usually occurs in children, only 15% of adults have a similar enzymatic disorder. Poor digestibility of nutrients from milk becomes a serious problem for the baby, especially for babies. After all, an adult can refuse to eat foods with lactose. For the infant, mother's milk and mixtures are the main food. And intolerance of the product always negatively affects the growth, weight and development of the baby.
What is lactose deficiency?
The composition of milk and dairy products is includedsugar substance of a group of carbohydrates. It is called lactose. Another name for this carbohydrate is milk sugar. For its processing in the body meets a special enzyme - lactase. This substance splits lactose into its constituent parts.
If a person has a deficiency of the enzyme lactase,then this pathology is called lactose deficiency. In this case, the milk sugar is not split into the intestines, which leads to diarrhea. Nutrients from products with lactose are not digested.
From a medical point of view it would be more correct to talk not about"lactose", but o"lactase"insufficiency. After all, the deficiency of the enzyme causes disturbances. However, the term "lactose deficiency" is rooted in everyday speech. This term is understood as a deficiency of lactase.
Symptoms of failure
Analysis for lactose deficiency is given to a baby with the following symptoms:
- The kid does not gain weight in weight, lags behind in development.
- Frequent regurgitation and colic, increased gassing.
- Disturbs the liquid stool of green color with an admixture of foam.
- Sometimes fecal masses become tight and come out with difficulty.
- There is a persistent deficiency of iron in the body.
- On the skin, inflammation can be noticed by the type of dermatitis.
Causes of lactase deficiency can bedifferent. Genetic pathology is very rare when the defect of the enzyme is congenital. This is the most difficult case. Sometimes this disorder is observed in premature infants. Their enzymatic system did not have time to fully form in the prenatal period. Often, lactose deficiency is the result of an allergic reaction to milk or bowel disease. In adults, such a disorder usually occurs because of age-related changes in the work of enzymes.
Sometimes diarrhea after breastfeeding occurswith the normal amount and activity of lactase. This suggests that the child is excessively overfed, and he has symptoms similar to lactose deficiency. What tests do you need to pass in order to distinguish the true deficiency of lactase from overeating of dairy food? Usually, the following studies are prescribed:
- analysis of feces for carbohydrates;
- coprogram with the determination of acidity;
- a blood test for a lactose curve;
- test for a genetic marker;
- hydrogen test;
- biopsy of the intestine (in very rare cases).
Fecal analysis for carbohydrates
The analysis of feces for lactose insufficiency isthe most simple and affordable. But it can not be said that this is the most informative study. This type of diagnosis is used for infants in combination with other methods.
Analysis does not need to be specially prepared. Nursing mother should not change her diet before examining the baby. The baby should eat as usual, only so you can get reliable results. It is necessary to take and carry for analysis about 1 teaspoon of baby feces. You can not collect feces from diapers or diapers. The material is recommended to be delivered to the laboratory within 4 hours. This will ensure the most accurate results of the analysis. It is allowed to store the biomaterial in the refrigerator for no more than 10 hours.
The study shows the amount of carbohydrates inkale, but it does not determine the type of sugary substances. But since the baby feeds only on milk, it is assumed that with feces lactose or products of its cleavage are released. However, it is impossible to understand which norm of the carbohydrate is exceeded. In addition to lactose in milk feeding with feces, galactose or glucose can be released.
The analysis of the analysis for lactose deficiency is as follows:
- The norm of carbohydrates is from 0.25% to 0.5%.
- In infants up to 1 month, reference values from 0.25% to 1% are allowed.
A more informative method is a coprogram. You should pay attention to such indicators as acidity (pH) and the amount of fatty acids. This is a simple and safe test for lactose insufficiency in the baby. The collection rules are the same as for carbohydrate research, but the material should be taken to the laboratory immediately. Otherwise, because of the microbes, the acidity will change.
Such an analysis for lactose deficiency is basedon the fact that when the lactase enzyme is deficient, the intestinal environment becomes more acidic. This is due to the fact that uncleaved lactase begins to ferment, while acids are released.
The normal pH of the feces is 5.5. Deviation from this indicator in the lower side indicates the presence of lactose deficiency. In this case, you need to consider the amount of fatty acids. The more of them, the higher the likelihood of the disease.
If the baby has signs of lactoseinsufficiency, what kind of analysis to pass better - a study for carbohydrates or a coprogram? This question is often of interest to parents. We can say that the level of acidity is more informative. But it is useful to pass both types of stool analysis, then one examination will complement the other.
Blood test for lactose curve
To the child on an empty stomach give to drink some milk. Then three times within an hour they take blood for analysis. This helps to trace the process of processing lactose in the body.
Based on the results, a speciallactose curve. It is compared with the average results of a glucose schedule. If the lactose curve is located below the glycemic curve, this may indicate a deficiency of the enzyme lactase.
This analysis for lactose deficiency is notalways well tolerated by infants. In fact if the child actually has such infringement after reception of milk on an empty stomach pains in a stomach and diarrhea can arise. However, this examination is more informative than the analysis of feces for carbohydrates.
In the air exhaled by a child,amount of hydrogen. With lactose deficiency in the intestine go fermentation. As a result, hydrogen is formed, which penetrates into the blood, and then exits through the respiratory system.
The child exhales into the measuring device. The concentration of hydrogen and other gases in the air leaving the lungs is fixed. This is the basic indicator. The patient is then given milk or a lactose solution. After this, repeat measurements of hydrogen are made, and the results are compared.
Normally, the deviation from the baseline after the lactose test should not be more than 0.002%. Excess of this number may indicate lactose deficiency.
This test is rarely performed with infants, usuallyit is used for older children and adults. The disadvantage of the test is the possible deterioration of well-being, if the child does suffer from lactose insufficiency.
Genetic analysis for lactose deficiency helps to detect this disorder if it is congenital. This study is for a special marker C13910T.
Blood is taken from the vein for analysis. The study is performed on an empty stomach or 3 hours after a meal. There are three possible outcomes of the analysis:
- C / C - this means that the child has a genetic lactose deficiency.
- C / T - this result indicates a patient's tendency to develop a secondary lactase deficiency.
- T / T - this means that a person has normal lactose tolerance.
This is a very reliable, but traumatic methodresearch. It is extremely rarely used in infants. Under anesthesia, a probe is inserted into the small intestine through the child's mouth. Under endoscopic control, pluck off pieces of mucosa and take them for histological examination.
In itself, a slight trauma to the mucosa is notIt is dangerous, because the epithelium is quickly restored. But anesthesia and the introduction of an endoscope can lead to complications. Therefore, when examining small children, this method is used only in the most extreme cases.
Lactose insufficiency in adults
In adults, lactose intolerance isor congenital, or caused by gastrointestinal diseases and age-related changes. The disease manifests itself in gastrointestinal disorders after consumption of dairy products. As a result, a person avoids eating food containing lactose. Because of this, his body lacks calcium, which has a negative effect on bone health.
In addition to the diagnostic methods listed above, there areanother analysis for lactose deficiency in adults. The patient is given a drink of 500 ml of milk, and then a blood test for sugar is taken. If the glucose level falls below 9 mg / dl, this indicates a violation of the absorption of lactose.
What to do if there is a deviation from the norm in the analyzes?
An incurable pathology is onlygenetically determined lactose intolerance. In this case, a lifelong diet and replacement therapy with lactase preparations are necessary. If lactose deficiency arose due to the child's shortage, then after some time the enzyme system still begins to develop, and the body is filled with lactase.
In all cases, the appointment of a diet withrestriction of dairy products. In some situations, lactose-free and low-lactose mixtures, as well as products with soy milk, are used to feed infants.
In the therapy of lactase deficiency, the following drugs are used:
- substitutes for the enzyme lactase;
- medicines for diarrhea and flatulence;
- antispasmodics from abdominal pain.
Adults are shown to use drugscalcium, because of the forced abandonment of dairy products, they have a higher risk of developing osteoporosis. In most cases, lactose deficiency has a favorable prognosis.