Examining this process through modern medicine reveals that the primary cause of abdominal pain after drinking milk is a deficiency in the enzyme lactase.
Milk contains a carbohydrate called lactose, which must be broken down in the small intestine into the simpler sugars glucose and galactose by the enzyme lactase to be absorbed. When this enzyme is deficient, undigested lactose bypasses the small intestine and moves directly into the large intestine. There, it serves as fuel for the resident gut microbiota. As these bacteria ferment the unabsorbed lactose, they produce gases such as hydrogen, methane, and carbon dioxide.
These gases cause abdominal distension, rumbling sounds known as borborygmus, and varying degrees of abdominal pain. Additionally, the fermented lactose draws water into the large intestine through an osmotic effect, leading to watery stools and diarrhea. This represents the basic biological mechanism of lactose intolerance.
Modern research also shows that additional factors influence the severity of these symptoms. The first factor is the composition of the gut microbiota. The extent of lactose fermentation varies depending on the specific strains and balance of bacteria present. A stable, balanced gut environment can temper reactions to unabsorbed sugars.
Second is intestinal motility, or the transit speed of contents through the gut. If motility is too slow, lactose remains in the large intestine longer, extending the window for fermentation. If motility is too rapid, lactase has inadequate contact time to digest lactose in the small intestine. Third is visceral hypersensitivity. Certain individuals possess heightened intestinal nerve sensitivity and perceive significant pain even from mild gas accumulation or normal levels of abdominal distension, a feature frequently observed in irritable bowel syndrome.
The concept of spleen-stomach deficiency cold in Donguibogam encompasses more than just a sensation of cold. Weakness and coldness in the spleen and stomach reflect an overarching state of intestinal hypofunction, aligning with modern concepts such as reduced digestive enzyme activity, altered intestinal motility, gut dysbiosis, and visceral hypersensitivity. It offers a systemic view, underscoring the importance of gently warming and supporting a depleted digestive system.
