How is lactose intolerance treated?

Lactose is the natural sugar in milk. When the body does not digest enough lactose, it can draw water into the bowel and be fermented by gut bacteria, leading to bloating, abdominal pain, wind or diarrhoea. Symptoms vary with the amount consumed and may be easier to manage when lactose is spread across meals.

A clinician may suggest a temporary reduction followed by careful reintroduction to identify your personal tolerance. Lactose-free milk, yoghurt or hard cheese may be suitable for some people. Nutrition counselling can help replace nutrients without removing more foods than necessary. Food intolerance testing may be considered when the diagnosis is uncertain or symptoms have another possible cause.

Keep a food and symptom diary, checking serving size, timing and ingredients in prepared foods. Try smaller portions with a meal rather than making a sudden, highly restrictive change. Choose calcium-containing alternatives and check their labels; a dietitian can help with calcium, vitamin D, protein and overall variety.

Lactose intolerance is different from a milk allergy. Hives, swelling, wheezing or breathing difficulty after dairy needs urgent medical attention rather than dietary trial and error. Do not label every digestive symptom as lactose intolerance without assessment.

Arrange medical review for ongoing diarrhoea, weight loss, blood in stool, night-time symptoms, repeated vomiting, severe abdominal pain or symptoms that continue despite reducing lactose. Seek emergency help for breathing difficulty, facial or throat swelling or collapse after eating dairy.

Ask whether your symptoms fit lactose intolerance, whether testing is useful, how much lactose to trial, and how to meet calcium and vitamin needs with your usual diet.