Lactose intolerance

Is the inability to digest lactose, a sugar found in milk and other dairy products and is caused by a deficiency of the enzyme lactase.

Alternative NamesMilk intolerance, lactase deficiency, disaccharidase deficiency, dairy product intolerance\

 Causes and Risk FactorsLactose intolerance occurs when the intestine does not produce enough lactase enzyme. Babies' bodies make this enzyme so they can digest milk, including breast milk. Before humans became farmers and processed dairy products, most people do not continue to drink milk in your life, so that did not produce lactase after early childhood.
People from cultures in which the consumption of milk and dairy products in adults occurred earliest are less likely to suffer from lactose intolerance than those belonging to villages where the consumption of dairy farming began more recently. As a result, lactose intolerance is more common in Asian, African American, Native American, and Mediterranean populations of northern and western Europe.
Lactose intolerance can begin at different times in life. In Caucasians, it usually starts to affect children older than 5 years, while the black people, the condition often occurs up to two years old.
When people with lactose intolerance eat or drink dairy products, may have symptoms such as bloating, excessive intestinal gas, nausea, diarrhea and abdominal cramps.
Lactose intolerance is not dangerous and is very common in adults. Approximately 30 million American adults have some degree of lactose intolerance by age 20 years.
Lactose intolerance is sometimes seen in premature babies and babies born at full term generally do not show signs of this condition until they are at least 3 years of age.
The fact of not having milk in the diet can cause a shortage of calcium, vitamin D, riboflavin and protein, so you need a milk substitute. Soy preparations are adequate substitutes for bottle babies under 2 years and for children toddlers, soy milk and rice are good alternatives. Older children may also consume cow's milk treated with lactase. Goat's milk is low in lactose, but should only be used with children if properly fortified with vitamins and essential amino acids.
Most people with low lactase can tolerate 2 to 4 ounces of milk at one time (up to half a cup), but larger portions (8 ounces) can cause problems for those with some degree of intolerance to milk.
Lactase deficiency may also occur as a result of intestinal diseases such as celiac sprue and gastroenteritis, or also manifest after intestinal surgery. This may be a temporary lactase deficiency due to bacterial or viral infections, especially in children, when injured cells lining the intestine. 
Symptoms

•     Abdominal cramps
•     Distension
•     Flatulence
•     Weight Loss
•     Malnutrition
•     Slow growth
•     Bloating
•     Diarrhea
•     Floating stools
•     Foul-smelling stools

Symptoms often occur after the ingestion of dairy products and often relieved by the suspension of the same. Large doses of milk products may cause worse symptoms.

Signs and tests

•     Test for stool-reducing substances
•     Proof of lactose tolerance
•     Breath test for lactose-hydrogen
•     Small bowel biopsy

Treatment
Symptoms usually are relieved with the suspension of dairy products in the diet, in which case it should be incorporated into food sources of calcium.
Usually can tolerate fermented milk products like yogurt. Sometimes, patients tolerate goat's milk, but it is recommended taken with meals, not alone. Also, consider that the butter milk and cheeses have less lactose than milk itself.
It may help to consumption of milk and lactose-free dairy products. Also, you can add lactase enzymes to regular milk or take them in capsule or chewable tablet form.
You should read food labels, because the lactose found in some non-milk products, including some beers. 
Expectations (prognosis)Usually, symptoms disappear once you stop consuming dairy products in the diet. 
ComplicationsPossible complications include weight loss and malnutrition. 
Calling your health careSeek medical attention if a child or adult has symptoms of lactose intolerance in order to seek food substitutes. Even when symptoms worsen or do not improve with treatment or if new symptoms. 
PreventionThere is no known way to prevent the development of lactose intolerance. However, if you have this condition, you can avoid or limit consumption of dairy products to reduce or eliminate symptoms.



source: clinicadam.com

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Osteomalacia: symptomes, sign and treatment

Osteomalacia
Is the softening of bones caused by a deficiency of vitamin D or problems with the metabolism (breakdown and use) of this vitamin. These softer bones have a normal amount of collagen that gives structure to bones, but lack of calcium.Causes and Risk Factors
Numerous causes of osteomalacia. In children, the condition is called rickets and causes often deficient in vitamin D.
Conditions that can lead to osteomalacia include:

•     Not enough vitamin D in the diet
•     Enough exposure to sunlight, which produces vitamin D in the body
•     Malabsorption of vitamin D from the gut

Other conditions that may cause osteomalacia include:

•     Hereditary or acquired disorders of the metabolism of vitamin D
•     Kidney failure and acidosis
•     Renal phosphate consumption associated with diets deficient in
•     Cancer
•     Side effects of medications used to treat seizures
•     Liver disease

The use of strong sunscreen, limited exposure of the body to sunlight, short days of sunlight, and smog are factors that reduce formation of vitamin D in the body.
Risk factors for osteomalacia are related to the causes. Among the elderly, there is an increased risk in those who tend to remain indoors and those who avoid milk because of lactose intolerance. 
Symptoms

•     Diffuse bone pain (not located at an exact point), especially in the hips
•     Muscle weakness
•     Bone fractures that occur with minimal trauma

Symptoms associated with low levels of calcium include:

•     Numbness around the mouth
•     Numbness of extremities
•     Spasms of the hands and feet
•     Abnormal heart rhythm

Signs and tests

•     A bone biopsy shows osteomalacia
•     The level of vitamin D levels may be low
•     Serum calcium levels vary with the cause of the disorder
•     Serum phosphate levels vary with the cause of the disorder
•     Bone x-rays may show features of osteomalacia, such as bowed legs or "pseudofractures"
•     A scan of the bone mineral density (DEXA) may show reduced bone density, a sign of weaker bones

You can perform other tests to determine if a kidney problem or any other underlying disorder. These may include:

•     PTH
•     Calcium (ionized)
•     Isoenzyme of alkaline phosphatase (ALP)

Treatment
May be given oral supplements of vitamin D, calcium and phosphorus, depending on the underlying cause of the disorder. They may require large doses of vitamin D and calcium in people with intestinal malabsorption.
You may also require controlling the levels of phosphorus and calcium in the blood in people with certain underlying conditions.Expectations (prognosis)
Improving the condition of the bones, seen through bone radiographs, can be seen in a few weeks in some people with vitamin deficiency disorders. Complete healing with this treatment is given within six months.Complications
The reappearance of symptoms is a possible complication.Calling your health care
The person should seek medical attention if symptoms of osteomalacia or think you may be at risk.Prevention
Adults can prevent osteomalacia resulting from vitamin D deficiency with an adequate intake of dairy products fortified with this vitamin, as with adequate exposure to sunlight.



source: clinicadam.com

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Osteomalacia is a bone disease

General
Osteomalacia is a bone disease in which bone density decreases due to vitamin D deficiency. The bone is about one-third of developed materials that are produced by special cells called osteoblasts. Two-thirds of the bone mass are made of minerals, especially calcium,

which are incorporated into this matrix and thereby give the bone until the necessary hardness. In osteomalacia can be absorbed into the body due to vitamin D deficiency, too little calcium in the gut. The bone is the resulting reduction of hard, mineralized bone, which is then replaced by non-mineralized matrix, much softer. The result is that the bone bends in the most polluted regions. Basically, the cause must be sought at all stages of calcium metabolism. Vitamin D, which is responsible for the uptake of calcium absorbed from food in the gut may be decreased due to a deficiency or malnutrition. Vitamin D can also by our bodies from its precursors, which we absorb from food, are formed. This requires that the precursors are converted in our body three times: once with the help of sunlight in the skin, a second time in the liver and a third time in the kidney. With lack of sunlight, as this can occur for example in nursing home residents, or kidney disease can therefore lead to a vitamin D deficiency. Some drugs, such as stomach acid blockers or some epilepsy medications can lead to different ways to a vitamin D deficiency and thus to a reduced calcium absorption in the intestine. Back to top Symptoms
Osteomalacia in the elderly is only symptomatic and develops insidiously. The extent of symptoms depends on the bone mass at the beginning of the disease and the cause of the disorder that leads to vitamin D deficiency. The initial symptoms are muscle weakness, joint pain and diffuse pain throughout the skeletal system. These symptoms are nonspecific and resemble normal age-related complaints. For this reason, the disease is often diagnosed only late, namely when she has osteoporosis-like symptoms. The reduced bone density facilitates the formation of vertebral fractures. After multiple spinal fractures can be in the top half of the back form a hump, which is also known as dowager's hump. The noticeable decrease in body size is also caused by vertebral fractures. Back to top Diagnosis
The physical examination contributes little to the disease at diagnosis. Note the body extending over the whole pain in the skeletal system. Especially painful are the higher stress regions of the musculoskeletal system. Through the bone remodeling produces substances that can be detected in the blood, especially the alkaline phosphatase. Crucial for the diagnosis of osteomalacia that is why the blood test, because at the very similar osteoporosis manifesting this degradation product can not be detected in unusually high amounts. With an X-ray image, the loss of bone mass are shown. Suspicious for osteomalacia are so-called conversion Looser zones, formed by the replacement of a hard, mineralized bone by soft bone. This conversion Looser zones are found mainly on exposed bone points and often lead to fatigue fractures. When x-ray of the spine the same changes are visible as in osteoporosis. Vertebral fractures by vertebral bodies are wedge-shaped or deformed fish, or it can be seen cranked deck or belly plates. Ambiguities must be removed during a bone sample, which after appropriate preparation, can be examined under a microscope. This can be distinguished from similar bone disease osteomalacia. Back to top Therapy
The treatment of osteomalacia is according to the underlying disorder in a supply of vitamin D. If a vitamin D deficiency due to a deficiency or malnutrition before, as can occur for example in strict vegetarians or a fat-free diet is taken vitamin D in the form of drops or capsules. If the fed vitamin D is indeed supplied in sufficient quantities, but can not be absorbed, the substance must be injected directly into the bloodstream. As described above, can disable various medications, vitamin D and thus lead to a vitamin deficiency. In this case, often very high doses of the vitamin is needed to compensate for the deficiency. If the cause of osteomalacia is corrected, may very pronounced and debilitating deformations of the musculoskeletal system may be removed by surgery.


source: eesom.com

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