By Abdellatif Sharaa

KUWAIT: Consultant of Internal Diseases, Digestive System and Liver Dr Wafaa Al-Hashash said according to a study she prepared, 82 percent of Kuwaitis, or nearly 1.165 million citizens, are lactose intolerant, which means they cannot digest lactose in dairy products. Dr Hashash said the study was conducted with patients who suffer from indigestion, flatulence, gas, change of toilet habits, constipation and diarrhea by taking a biopsy from the small intestine while having an endoscopy, then testing for the lactase enzyme.

"Under normal circumstances, lactase turns lactose into two simple sugars - glucose and galactose, and they are absorbed through the small intestine's lining into the blood stream. In case of shortage of lactase, the lactose in food goes into the colon instead of being processed and absorbed in the small intestine. The indigested lactose reacts with natural flora in the colon and causes symptoms of lactose intolerance," she said.

Dr Wafaa Al-Hashash

Dr Hashash said there are several types of lactose intolerance, including primary lactose intolerance, which is most common, as patients start their lives by producing enough lactase. Then when children replace milk with other foods, the amount of lactase goes down naturally, but it normally remains high enough to digest the amount of milk available in the food of grownup individuals. She said in case of primary lactose intolerance, lactase production drops severely with maturity, making digestion of dairy products difficult.

Dr Hashash said secondary lactose intolerance occurs when the small intestine produces lesser lactase following an illness or surgery such as intestinal infection, celiac disease, Crohn's disease and overgrowth of bacteria in the small intestine. She said there are risk factors that make the person more likely to have lactose intolerance, including advanced age, ethnicity, premature birth, small intestine diseases, certain medicines and cancer treatments.

Dr Hashash said lactose forms around 20 percent of medicine formulae, such as contraceptive tablets, and indigestion pills, so the patient should ask the doctor about medicines that have lactose. Treatment of lactose intolerance depends on the severity of symptoms and includes reducing the amount of milk and dairy products, eating products that have lesser amounts of lactose or taking alternative products such as soy and almond milk. Those who are lactose intolerant should look for other sources to compensate for calcium and vitamin D such as almonds, sardines, tuna, salmon and soy products.