Lactose Intolerance Treatment & Management

Updated: Dec 04, 2019
  • Author: Praveen K Roy, MD, MSc; Chief Editor: Burt Cagir, MD, FACS  more...
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Medical Care

Dietary adjustment is the primary form of therapy for patients with lactose intolerance. [27, 28] Advise patients to reduce or restrict products containing lactose. Prehydrolyzed milk (LACTAID) is available and is effective. Yogurt and fermented products, such as cheeses, are better tolerated than regular milk. Soy-based milk or food products are well tolerated.

Commercially available lactase enzyme preparations (eg, LACTAID, Lactrase) are effective in reducing symptoms; however, they may not be effective in some patients, partially due to insufficient dosing.

Plant-based milk alternatives are emerging; however, although these products show some potential, technologic, palatability, and/or nutritional balance issues remain a concern. [29, 30]

Probiotics (DDS-1 strain of Lactobacillus) have been shown to improve symptoms. [31, 32]

Supplemental calcium and vitamin D should also be recommended. [15]

In secondary lactase deficiency, treatment is directed at the underlying cause. [33]


Consider consulting with a gastroenterologist and a nutritionist in the management of patients with suspected lactose intolerance.


Note the following dietary considerations in patients with lactose intolerance:

  • Patients should read labels on commercial products.

  • Patients should avoid or reduce intake of lactose-containing foods.

  • Most patients who are lactose intolerant can ingest as much as 240 mL of milk without an exacerbation of their symptoms. [34]

  • Whole milk and chocolate milk may be better tolerated than skim milk. [35]

  • Certain medications and foods contain hidden lactose, such as breads, margarine, salad dressings, and candies.