Food intolerance and allergy are both examples of ‘food hypersensitivity’ but they differ in the type of reaction triggered by the body.
Lactose intolerance is where there is reduced capacity to digest lactose, a sugar naturally found in all mammalian milk due to an absence or deficiency of the enzyme lactase in the small intestine.
Malabsorption, therefore, occurs when lactose passes through the intestines without being absorbed, acting as a bacterial substrate in the colon which fuels gastrointestinal symptoms such as:
The degree of gastrointestinal symptoms is dependent on the amount of lactose ingested and levels of lactase present in the small intestine1.
CMA, also known as Cow’s Milk Protein Allergy (CMPA), is an immunologic hypersensitivity to one or more of the proteins found in milk. This allergy is particularly prominent in infants and young children4 5. Typically, it presents in early infancy soon after initial exposure to cow’s milk protein in formula or weaning solids but also in a lower incidence of exclusively breastfed infants6. The prognosis is good with up to 75% of children outgrowing a milk allergy7.
CMA can present as a broad range of symptoms involving many organ systems depending on the type of immune reaction causing the allergic response. Discriminating between the type of reaction is important as can affect risk status of developing other food allergies and atopic disease8.
There are two main types of CMA:
It can sometimes be difficult to differentiate between CMA and lactose intolerance, as some digestive symptoms overlap such as nausea, abdominal pain, and diarrhoea. However, there are some distinct differences to be aware of that can help inform diagnosis and, therefore, ensure correct management.
|Age / point of onset|
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