Lactose intolerance causes: Difference between revisions

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{{CMG}}; {{AE}} {{MA}}
{{CMG}}; {{AE}} {{MA}}
==Overview==
==Overview==
Disease name] may be caused by [cause1], [cause2], or [cause3].
The most common cause of lactose intolerance is acquired primary lactase deficiency. Less common causes of lactose intolerance include [[Small intestinal bacterial overgrowth]], [[Infection|Infections]] such as [[giardiasis]], [[Drug]] induced enteritis, [[Celiac disease|Celiac sprue]], [[Tropical sprue]], and [[Whipple's disease]].
 
OR
 
Common causes of [disease] include [cause1], [cause2], and [cause3].
 
OR
 
The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
 
OR
 
The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click [[Pericarditis causes#Overview|here]].


==Causes==
==Causes==
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===Common Causes===
===Common Causes===
Lactose intolerance may be caused by:
The most common cause of lactose intolerance is
*Acquired primary lactase deficiency ( lactase nonpersistence, adult-type hypolactasia)<ref name="pmid11788828">{{cite journal |vauthors=Enattah NS, Sahi T, Savilahti E, Terwilliger JD, Peltonen L, Järvelä I |title=Identification of a variant associated with adult-type hypolactasia |journal=Nat. Genet. |volume=30 |issue=2 |pages=233–7 |year=2002 |pmid=11788828 |doi=10.1038/ng826 |url=}}</ref><ref name="pmid17159977">{{cite journal |vauthors=Tishkoff SA, Reed FA, Ranciaro A, Voight BF, Babbitt CC, Silverman JS, Powell K, Mortensen HM, Hirbo JB, Osman M, Ibrahim M, Omar SA, Lema G, Nyambo TB, Ghori J, Bumpstead S, Pritchard JK, Wray GA, Deloukas P |title=Convergent adaptation of human lactase persistence in Africa and Europe |journal=Nat. Genet. |volume=39 |issue=1 |pages=31–40 |year=2007 |pmid=17159977 |pmc=2672153 |doi=10.1038/ng1946 |url=}}</ref>
*Acquired primary lactase deficiency (lactase nonpersistence, adult-type hypolactasia)<ref name="pmid11788828">{{cite journal |vauthors=Enattah NS, Sahi T, Savilahti E, Terwilliger JD, Peltonen L, Järvelä I |title=Identification of a variant associated with adult-type hypolactasia |journal=Nat. Genet. |volume=30 |issue=2 |pages=233–7 |year=2002 |pmid=11788828 |doi=10.1038/ng826 |url=}}</ref><ref name="pmid17159977">{{cite journal |vauthors=Tishkoff SA, Reed FA, Ranciaro A, Voight BF, Babbitt CC, Silverman JS, Powell K, Mortensen HM, Hirbo JB, Osman M, Ibrahim M, Omar SA, Lema G, Nyambo TB, Ghori J, Bumpstead S, Pritchard JK, Wray GA, Deloukas P |title=Convergent adaptation of human lactase persistence in Africa and Europe |journal=Nat. Genet. |volume=39 |issue=1 |pages=31–40 |year=2007 |pmid=17159977 |pmc=2672153 |doi=10.1038/ng1946 |url=}}</ref>


===Less Common Causes===
===Less Common Causes===
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* Secondary lactose malabsorption<ref name="pmid9742907">{{cite journal |vauthors=Srinivasan R, Minocha A |title=When to suspect lactose intolerance. Symptomatic, ethnic, and laboratory clues |journal=Postgrad Med |volume=104 |issue=3 |pages=109–11, 115–6, 122–3 |year=1998 |pmid=9742907 |doi=10.3810/pgm.1998.09.577 |url=}}</ref><ref name="pmid24917953">{{cite journal |vauthors=Misselwitz B, Pohl D, Frühauf H, Fried M, Vavricka SR, Fox M |title=Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment |journal=United European Gastroenterol J |volume=1 |issue=3 |pages=151–9 |year=2013 |pmid=24917953 |pmc=4040760 |doi=10.1177/2050640613484463 |url=}}</ref><ref name="pmid120188073">{{cite journal |vauthors=Swagerty DL, Walling AD, Klein RM |title=Lactose intolerance |journal=Am Fam Physician |volume=65 |issue=9 |pages=1845–50 |year=2002 |pmid=12018807 |doi= |url=}}</ref><ref name="pmid9219788">{{cite journal |vauthors=Mishkin B, Yalovsky M, Mishkin S |title=Increased prevalence of lactose malabsorption in Crohn's disease patients at low risk for lactose malabsorption based on ethnic origin |journal=Am. J. Gastroenterol. |volume=92 |issue=7 |pages=1148–53 |year=1997 |pmid=9219788 |doi= |url=}}</ref>
* Secondary lactose malabsorption<ref name="pmid9742907">{{cite journal |vauthors=Srinivasan R, Minocha A |title=When to suspect lactose intolerance. Symptomatic, ethnic, and laboratory clues |journal=Postgrad Med |volume=104 |issue=3 |pages=109–11, 115–6, 122–3 |year=1998 |pmid=9742907 |doi=10.3810/pgm.1998.09.577 |url=}}</ref><ref name="pmid24917953">{{cite journal |vauthors=Misselwitz B, Pohl D, Frühauf H, Fried M, Vavricka SR, Fox M |title=Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment |journal=United European Gastroenterol J |volume=1 |issue=3 |pages=151–9 |year=2013 |pmid=24917953 |pmc=4040760 |doi=10.1177/2050640613484463 |url=}}</ref><ref name="pmid120188073">{{cite journal |vauthors=Swagerty DL, Walling AD, Klein RM |title=Lactose intolerance |journal=Am Fam Physician |volume=65 |issue=9 |pages=1845–50 |year=2002 |pmid=12018807 |doi= |url=}}</ref><ref name="pmid9219788">{{cite journal |vauthors=Mishkin B, Yalovsky M, Mishkin S |title=Increased prevalence of lactose malabsorption in Crohn's disease patients at low risk for lactose malabsorption based on ethnic origin |journal=Am. J. Gastroenterol. |volume=92 |issue=7 |pages=1148–53 |year=1997 |pmid=9219788 |doi= |url=}}</ref>
** [[Small intestinal bacterial overgrowth]]
** [[Small intestinal bacterial overgrowth]]
** Infections such as [[giardiasis]] 
** [[Infection|Infections]] such as [[giardiasis]] 
** [[Drug]] induced enteritis
** [[Drug]] induced enteritis
** [[Radiation therapy|Radiation]] induced enteritis
** [[Radiation therapy|Radiation]] induced enteritis
** [[Human Immunodeficiency Virus (HIV)|HIV]] [[enteropathy]]
** [[Human Immunodeficiency Virus (HIV)|HIV]] [[enteropathy]]
** [[Sprue]] ([[Celiac disease|celiac]] and [[Tropical sprue|tropical]])
** [[Celiac disease|Celiac sprue]]
** [[Tropical sprue]]
** [[Whipple's disease]] ([[intestinal lipodystrophy]])
** [[Whipple's disease]] ([[intestinal lipodystrophy]])
** Severe [[gastroenteritis]]
** Severe [[gastroenteritis]]
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** [[Kwashiorkor]]
** [[Kwashiorkor]]
** [[Zollinger-Ellison syndrome]]
** [[Zollinger-Ellison syndrome]]
** [[Iatrogenic]] such as [[chemotherapy]] 
** [[Iatrogenic]] causes such as [[chemotherapy]] 
*Congenital lactase deficiency<ref name="pmid8523189">{{cite journal |vauthors=Saarela T, Similä S, Koivisto M |title=Hypercalcemia and nephrocalcinosis in patients with congenital lactase deficiency |journal=J. Pediatr. |volume=127 |issue=6 |pages=920–3 |year=1995 |pmid=8523189 |doi= |url=}}</ref>
*[[Congenital disorder|Congenital]] [[lactase]] deficiency<ref name="pmid8523189">{{cite journal |vauthors=Saarela T, Similä S, Koivisto M |title=Hypercalcemia and nephrocalcinosis in patients with congenital lactase deficiency |journal=J. Pediatr. |volume=127 |issue=6 |pages=920–3 |year=1995 |pmid=8523189 |doi= |url=}}</ref>
*Developmental lactase deficiency<ref name="pmid2578223">{{cite journal |vauthors=Mobassaleh M, Montgomery RK, Biller JA, Grand RJ |title=Development of carbohydrate absorption in the fetus and neonate |journal=Pediatrics |volume=75 |issue=1 Pt 2 |pages=160–6 |year=1985 |pmid=2578223 |doi= |url=}}</ref>
*Developmental [[lactase]] deficiency<ref name="pmid2578223">{{cite journal |vauthors=Mobassaleh M, Montgomery RK, Biller JA, Grand RJ |title=Development of carbohydrate absorption in the fetus and neonate |journal=Pediatrics |volume=75 |issue=1 Pt 2 |pages=160–6 |year=1985 |pmid=2578223 |doi= |url=}}</ref>


===Genetic Causes===
===Genetic Causes===
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|- bgcolor="LightSteelBlue"
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| '''Endocrine'''
| '''Endocrine'''
| bgcolor="Beige" | No underlying causes
| bgcolor="Beige" | [[Carcinoid syndrome]], Diabetic gastropathy, [[Kwashiorkor]], [[Zollinger-Ellison syndrome]] 
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
| bgcolor="Beige" | Acquired primary lactase deficiency,  [[Small intestinal bacterial overgrowth]], [[Drug]] induced enteritis, [[Radiation therapy|Radiation]] induced enteritis, [[Human Immunodeficiency Virus (HIV)|HIV]] [[enteropathy]], [[Tropical sprue]], [[Celiac disease|Celiac sprue]], [[Whipple's disease]], [[Gastroenteritis]]
| bgcolor="Beige" | Acquired primary lactase deficiency,  [[Small intestinal bacterial overgrowth]], [[Drug]] induced enteritis, [[Radiation therapy|Radiation]] induced enteritis, [[Human Immunodeficiency Virus (HIV)|HIV]] [[enteropathy]], [[Tropical sprue]], [[Celiac disease|Celiac sprue]], [[Whipple's disease]], [[Gastroenteritis]], [[Carcinoid syndrome]], [[Cystic fibrosis]], Diabetic gastropathy,
[[Kwashiorkor]], [[Zollinger-Ellison syndrome]]
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
| bgcolor="Beige" | [[Celiac disease|Celiac sprue]],  
| bgcolor="Beige" | [[Celiac disease|Celiac sprue]], lactase-phlorizin hydrolase (LPH) gene mutation 
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
| bgcolor="Beige" | [[Radiation therapy|Radiation]] induced enteritis,   
| bgcolor="Beige" | [[Radiation therapy|Radiation]] induced enteritis, [[Chemotherapy]]     
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | [[Celiac disease|Celiac sprue]],  
| bgcolor="Beige" | [[Celiac disease|Celiac sprue]], [[Cystic fibrosis]], 
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
| bgcolor="Beige" | No underlying causes
| bgcolor="Beige" | [[Carcinoid syndrome]], [[Zollinger-Ellison syndrome]], 
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
| bgcolor="Beige" | No underlying causes
| bgcolor="Beige" |[[Cystic fibrosis]],
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
List the causes of the disease in alphabetical order.
List the causes of the disease in alphabetical order.
{{columns-list|3|
{{columns-list|
* Cause 1
*Acquired primary lactase deficiency
* Cause 2
*[[Carcinoid syndrome]]
* Cause 3
*[[Congenital]] [[lactase]] deficiency
* Cause 4
*[[Cystic fibrosis]]
* Cause 5
*Developmental [[lactase]] deficiency
* Cause 6
*[[Diabetic gastropathy]]
* Cause 7
*[[Drug]] induced enteritis
* Cause 8
*[[HIV]] enteropathy
* Cause 9
*[[Iatrogenic]] such as [[chemotherapy]]
* Cause 10
*[[Infections]] such as [[giardiasis]]
*[[Kwashiorkor]]
*lactase-phlorizin hydrolase (LPH) gene [[mutation]]
*[[Radiation]] induced enteritis
*Severe [[gastroenteritis]]
*[[Small intestinal bacterial overgrowth]]
*[[Celiac sprue]]
*[[Tropical sprue]]
*[[Whipple's disease]]
*[[Zollinger-Ellison syndrome]]
}}
}}


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{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category: (name of the system)]]
__NOTOC__
{{Lactose intolerance}}
{{CMG}}
==Overview==
==Causes==
Some causes of lactose intolerance are well known. Primary [[lactase]] deficiency is a condition that develops over time. After about age 2 the body begins to produce less lactase, though most people will not notice symptoms until they are much older. Secondary lactase deficiency occurs when injury to the small intestine or certain digestive diseases reduce the amount of lactase a person produces. These diseases include [[celiac disease]], [[inflammatory bowel disease]], and [[Crohn’s disease]].
==References==
{{Reflist|2}}
{{WS}}
{{WH}}


[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Endocrinology]]
[[Category:Medicine]]
[[Category:Needs content]]
[[Category:Up-To-Date]]
[[Category:Needs overview]]

Latest revision as of 22:28, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]

Overview

The most common cause of lactose intolerance is acquired primary lactase deficiency. Less common causes of lactose intolerance include Small intestinal bacterial overgrowth, Infections such as giardiasis, Drug induced enteritis, Celiac sprue, Tropical sprue, and Whipple's disease.

Causes

Life-threatening Causes

  • Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life-threatening causes of lactose intolerance.

Common Causes

The most common cause of lactose intolerance is

  • Acquired primary lactase deficiency (lactase nonpersistence, adult-type hypolactasia)[1][2]

Less Common Causes

Less common causes of lactose intolerance include:

Genetic Causes

  • Lactose intolerance is caused by a mutation in the lactase-phlorizin hydrolase (LPH) gene.[9][10][11]

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Celiac sprue,
Drug Side Effect Drug induced enteritis,
Ear Nose Throat No underlying causes
Endocrine Carcinoid syndrome, Diabetic gastropathy, Kwashiorkor, Zollinger-Ellison syndrome
Environmental No underlying causes
Gastroenterologic Acquired primary lactase deficiency, Small intestinal bacterial overgrowth, Drug induced enteritis, Radiation induced enteritis, HIV enteropathy, Tropical sprue, Celiac sprue, Whipple's disease, Gastroenteritis, Carcinoid syndrome, Cystic fibrosis, Diabetic gastropathy,

Kwashiorkor, Zollinger-Ellison syndrome

Genetic Celiac sprue, lactase-phlorizin hydrolase (LPH) gene mutation
Hematologic No underlying causes
Iatrogenic Radiation induced enteritis, Chemotherapy 
Infectious Disease Infections such as giardiasis, HIV enteropathy, Tropical sprue, Whipple's disease,
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Celiac sprue, Cystic fibrosis,
Obstetric/Gynecologic No underlying causes
Oncologic Carcinoid syndrome, Zollinger-Ellison syndrome,
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Cystic fibrosis,
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Celiac sprue
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

List the causes of the disease in alphabetical order.

References

  1. ↑ Enattah NS, Sahi T, Savilahti E, Terwilliger JD, Peltonen L, Järvelä I (2002). "Identification of a variant associated with adult-type hypolactasia". Nat. Genet. 30 (2): 233–7. doi:10.1038/ng826. PMID 11788828.
  2. ↑ Tishkoff SA, Reed FA, Ranciaro A, Voight BF, Babbitt CC, Silverman JS, Powell K, Mortensen HM, Hirbo JB, Osman M, Ibrahim M, Omar SA, Lema G, Nyambo TB, Ghori J, Bumpstead S, Pritchard JK, Wray GA, Deloukas P (2007). "Convergent adaptation of human lactase persistence in Africa and Europe". Nat. Genet. 39 (1): 31–40. doi:10.1038/ng1946. PMC 2672153. PMID 17159977.
  3. ↑ Srinivasan R, Minocha A (1998). "When to suspect lactose intolerance. Symptomatic, ethnic, and laboratory clues". Postgrad Med. 104 (3): 109–11, 115–6, 122–3. doi:10.3810/pgm.1998.09.577. PMID 9742907.
  4. ↑ Misselwitz B, Pohl D, Frühauf H, Fried M, Vavricka SR, Fox M (2013). "Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment". United European Gastroenterol J. 1 (3): 151–9. doi:10.1177/2050640613484463. PMC 4040760. PMID 24917953.
  5. ↑ Swagerty DL, Walling AD, Klein RM (2002). "Lactose intolerance". Am Fam Physician. 65 (9): 1845–50. PMID 12018807.
  6. ↑ Mishkin B, Yalovsky M, Mishkin S (1997). "Increased prevalence of lactose malabsorption in Crohn's disease patients at low risk for lactose malabsorption based on ethnic origin". Am. J. Gastroenterol. 92 (7): 1148–53. PMID 9219788.
  7. ↑ Saarela T, Similä S, Koivisto M (1995). "Hypercalcemia and nephrocalcinosis in patients with congenital lactase deficiency". J. Pediatr. 127 (6): 920–3. PMID 8523189.
  8. ↑ Mobassaleh M, Montgomery RK, Biller JA, Grand RJ (1985). "Development of carbohydrate absorption in the fetus and neonate". Pediatrics. 75 (1 Pt 2): 160–6. PMID 2578223.
  9. ↑ Enattah NS, Sahi T, Savilahti E, Terwilliger JD, Peltonen L, Järvelä I (2002). "Identification of a variant associated with adult-type hypolactasia". Nat. Genet. 30 (2): 233–7. doi:10.1038/ng826. PMID 11788828.
  10. ↑ Kuokkanen M, Enattah NS, Oksanen A, Savilahti E, Orpana A, Järvelä I (2003). "Transcriptional regulation of the lactase-phlorizin hydrolase gene by polymorphisms associated with adult-type hypolactasia". Gut. 52 (5): 647–52. PMC 1773659. PMID 12692047.
  11. ↑ Rasinperä H, Savilahti E, Enattah NS, Kuokkanen M, Tötterman N, Lindahl H, Järvelä I, Kolho KL (2004). "A genetic test which can be used to diagnose adult-type hypolactasia in children". Gut. 53 (11): 1571–6. doi:10.1136/gut.2004.040048. PMC 1774274. PMID 15479673.

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