Malabsorción e intolerancia a la lactosa
DOI:
https://doi.org/10.52787/agl.v55i2.495Palabras clave:
Lactosa, lactasa, intolerancia, malabsorción, hipolactasiaResumen
La malabsorción de lactosa y la intolerancia a la lactosa son condiciones frecuentes, clínicamente distintas. La malabsorción de lactosa se refiere al paso de este carbohidrato no digerido al colon, debido a deficiencia de lactasa, mientras que la intolerancia implica la aparición de síntomas gastrointestinales tras su ingesta, en presencia de malabsorción. La alactasia es una forma congénita rara de ausencia total de actividad de la lactasa. La hipolactasia primaria es una reducción fisiológica y genética de la lactasa en la edad adulta. La prevalencia global de malabsorción alcanza hasta dos tercios de la población, con cifras elevadas en América Latina y México. El diagnóstico puede realizarse mediante pruebas no invasivas, como la prueba de aliento con lactosa, pruebas genéticas, test de gaxilosa y prueba de tolerancia a la lactosa; o bien mediante métodos invasivos como la medición enzimática en biopsias duodenales. El tratamiento debe centrarse en controlar los síntomas sin comprometer el estado nutricional, mediante dietas bajas en lactosa, suplementos de lactasa exógena y el uso de probióticos o prebióticos. Es fundamental evitar restricciones innecesarias que puedan llevar a deficiencias nutricionales o a trastornos alimentarios, como el de restricción o evitación de la ingesta de alimentos. Un enfoque diagnóstico y terapéutico individualizado mejora la calidad de vida y el manejo clínico de estos pacientes.
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