however, damage to the brush border of the small intestine mucosa where lactase is present may lead to a secondary lactase deficiency and subsequent inability to digest lactose properly
partially or minimally digested lactose moves into the colon where it is fermented by enteric bacteria resulting in hydrogen, carbon dioxide, and acids
these byproducts result in symptoms reported for those with lactase deficiency: cramps, abominal pain and distension, and flatulence
the increased solute load in the large intestine leads to increased osmotic pressure, causing watery diarrhea
early refeeding following gastroenteritis is recommended, but many clinicians recommend dairy restricted diets acutely
