What is the cause of diarrhea in children with lactose intolerance?

The article is professionally consulted by Master, Doctor Dang Huy Toan - Pediatrician - Neonatologist - Department of Pediatrics - Neonatal - Vinmec Nha Trang International General Hospital.

Children with diarrhea when lactose intolerant is a common clinical condition and is one of the causes of persistent diarrhea. Lactose intolerance can occur as a natural defect of the digestive system or secondary to damage to intestinal villi after an acute episode of diarrhea.

Lactose is a type of sugar, abundant in the composition of milk, especially animal milk. Glucose from the sugar lactose is a source of energy for the brain and other organs in the body. Along with many types of beneficial bacteria in the intestinal tract such as lactobacillus, lactose supports the activity and maintenance of the balance of the natural microflora in the intestinal tract, promoting the activity of the immune system and the development of children. The enzyme lactase is secreted from the intestinal microvilli and is responsible for digesting lactose into two smaller sugar molecules, glucose and galactose, for absorption and use by the body.
Lactose intolerance occurs when there is not enough lactase enzyme in the baby's body to metabolize it in a normal way. Excess lactose from milk will be metabolized by another route to produce lactic acid. It is this new product that creates clinical symptoms when children are lactose intolerant such as abdominal distension, diarrhea with sour-smelling stools, red skin around the anus. Symptoms of diarrhea in children with lactose intolerance vary depending on the amount of lactose supplied to the body.

Lactose intolerance diarrhea occurs when the body does not produce enough lactase enzyme. There are many possible causes of lactase deficiency which are listed below:
Primary: Deficiency is defined as relative when lactase production is insufficient without being associated with any disease. any reason. Abnormal primary lactose intolerance is the most common cause, occurs in many children and is associated with several different ethnicities. Secondary: damage to intestinal microvilli after abnormal diseases in the gastrointestinal tract such as diarrhea caused by Rotavirus infection, causing children to have lactose intolerance. The microvilli system does not produce lactase, which prevents the body from absorbing lactose. Therefore, the symptoms of diarrhea last longer and are more severe, forming a pathological circle. The more severe the diarrhea, the greater the degree of damage to the microvilli. Congenital: Chromosomal abnormalities may inactivate the region of the gene that regulates lactase production. Then the enzyme deficiency can become absolute, making the disease worse. However, congenital causes are quite rare in clinical practice.

Children with lactose intolerance diarrhea appear at any age with varying degrees and complications. Depending on each specific case, the treatment for children with lactose intolerance is also different.
With the group of breastfed children, breastfeeding should not be interrupted even if the child is having diarrhea. Do not replace breast milk with other milks or reduce the number of feedings for your baby as this can cause malnutrition, making diarrhea last and take longer to recover. Breast milk is a complete source of nutrients and energy for babies. Lactose in breast milk is still partially absorbed even though the body lacks the enzyme lactase. In addition, breast milk has the ability to promote the recovery and regeneration of intestinal mucosa after infections. The frequency of loose stools was reduced in breastfed infants compared with cow's milk-fed infants. Oresol solution should be added when the child is having acute diarrhea.
In fact, many parents have misconceptions about the treatment of lactose-intolerant diarrhea in children. Stopping breast milk, following a strict diet and arbitrarily using antibiotics are ineffective measures, adversely affecting the health of young children. Stopping breast milk and restricting the supply of nutritious foods leads to nutritional deficiencies and general weakness. When it is suspected that a child has diarrhea due to lactose intolerance, the rule to follow is to eliminate foods containing lactose from the child's diet. Choose specific milk alternatives that do not contain lactose during times of diarrhea. Lactose milk can be reintroduced about 1 to 2 weeks after the diarrhea has ended, when the intestinal mucosa has recovered and is able to produce sufficient lactase. Lactose-free milk products or lactofree milk are also suitable choices in cases of non-lactose-related diarrhea because of their ability to quickly reduce diarrhea symptoms in children. This is a supportive food that provides enough energy and nutrients during the period of diarrhea.
The diet of children with diarrhea when lactose intolerant should be supplemented with calcium because the lack of lactose in food will prevent the body's absorption of calcium. Therefore, it is necessary to continue to give children lactofree milk and calcium-rich products that are not derived from milk such as snails, shrimps, crabs, vegetables ...

In addition, when children have signs of acute diarrhea, dehydration, difficulty in handling, and worsening over time, parents need to take the child to a medical center immediately for timely diagnosis and treatment. time. Infectious diarrhea, if diagnosed and treated late, can lead to secondary lactose intolerance.
Vinmec International General Hospital is the address for receiving and examining respiratory diseases that infants and young children are susceptible to: viral fever, bacterial fever, respiratory infection, pneumonia In children, acute diarrhea....With modern equipment, sterile space, minimizing the impact as well as the risk of disease spread. Along with that is the dedication from the doctors with professional experience with pediatric patients, making the examination no longer a concern of the parents.