A boy comes with complains of vomiting, bloated abdomen and abdominal pain. He has history of attending ice-cream eating competition last night. He also has past history of similar episodes following ingestion of milk and milk products. The likely cause -
Pancreatic amylase deficiency
Lactase deficiency
Salivary amylase deficiency
Food poisoning
Ans. is 'b' i.e., Lactase deficiency History of ice cream ingestion and subsequent symptoms of vomiting, bloated abdomen, are characteristic findings of lactase deficiency. Lactase deficiency ? o Lactase is a disaccharidase present on intestinal epithelium (brush border)*. It is used to digest lactose (disaccharide). Symptoms arise after ingestion offood containing lactose (e.g. milk). Symptom - Diarrhoea, vomiting, bloated abdomen. o Diagnosis Presence of more than '/2 percent of reducing substrate in fresh stool. Acidic stools Abnormal oral sugar tolerance test* (blood glucose rise of less than 20mg/d1 above fasting level with a disaccharide load of 2g/kg) Breath H, excretion of more than 11 ppm*. Enzyme assay on mucosal biopsies showing low levels of disaccharidases. o Treatment - low lactose diet.