Lactose intolerance is not curable, but the good news is that it is treatable. The following are the major lines of treatment for this condition:




The most common and also the most obvious means of treating lactose intolerance is by dietary changes, i.e., reducing or eliminating lactose in the diet. This is not child’s play. Dairy-based foods are as common on supermarket shelves as they are in restaurants, and a rigorous elimination diet is challenging to initiate and even more difficult to stick with. Dairy is so pervasive that people with severe lactose intolerance attempting an elimination diet may still inadvertently be ingesting enough milk-based products to continue having symptoms, and they may in fact falsely conclude that lactose intolerance is not responsible for their symptoms. A rigorous elimination of dairy from your diet may in fact not be necessary. Most lactose intolerant people can tolerate small to moderate amounts of lactose and only require elimination of the major milk-containing products from their diet to obtain relief from their symptoms. It may only be necessary to eliminate milk, yogurt, cheese, and ice cream. Although yogurt contains large amounts of lactose, it is peculiarly well tolerated by people with lactose intolerance. This may be because the bacteria used to make yogurt contain lactase enzyme, and this lactase is able to help break down some of the lactose sugar in the yogurt while it is stored and even after it is eaten. Yogurt also has been shown to empty more slowly from the stomach than milk, allowing the enzyme a longer time to break down the lactose, which results in less undigested lactose reaching the colon, and therefore fewer symptoms. However, for severely lactose-intolerant people, dietary restrictions will need to be rigorous. Any product containing milk must be avoided and all prepared foods containing dairy products must be eliminated from the diet including food purchased from the supermarket and food in restaurants that may have dairy-based sauces.




Larger supermarkets carry milk that has the lactose already broken down by the addition of lactase enzyme. Substitutes like soy milk are also options.




Caplets or tablets of lactase are available to take with milk-containing foods. These are particularly helpful if the exact ingredients in a meal are unknown.




Some people find that by gradually increasing the amount of milk in their diets they are able to tolerate larger amounts of lactose without developing symptoms. This tolerance to increasing amounts of milk is not due to increase in lactase, but probably results from alterations in the bacterial milieu of the colon.




The role of calcium in maintaining bone health is well established, especially in children with growing bones, teens, pregnant women, and postmenopausal women with “thinner” bones. Milk and milk-containing products are rich sources of calcium, and therefore calcium deficiency is common among lactose-intolerant persons. This deficiency of calcium increases the risk and severity of osteoporosis (thinning of bones) and can result in fractures. It is therefore necessary for lactose-intolerant persons to supplement their diets with additional calcium. To absorb calcium, the body needs vitamin D, which people get by being out in the sun. Good sources of vitamin D are fortified orange juice, soy milk, and cereals, as well as oily fish like salmon, egg yolk, and liver. Deficiency of vitamin D also causes diseases of the bones and increased susceptibility to fractures. Milk is fortified with vitamin D and is a sizeable source of vitamin D for most people. It is therefore a good idea for lactose-intolerant persons to take supplemental vitamin D as well.




Effective treatment of lactose intolerance may require counseling by a nutritionist or dietician in conjunction with your treating physician. Reading books and guides on lactose-elimination diets and trolling the Internet, a goldmine of information, will leave you armed with information that will help keep distressing symptoms at bay using lifestyle and diet modification.


Over time, the majority of people who have to live with lactose intolerance learn to treat their condition by understanding their bodies and gut function well enough to manage their symptoms effectively.