Approach dietary management for a patient diagnosed with lactose intolerance by first advising the patient to reduce or avoid lactose-containing foods to alleviate symptoms, as lactose intolerance results from the inability to digest lactose due to lactase deficiency Montalto et al. 2006. Encourage the patient to identify their individual tolerance threshold, as some may tolerate small amounts of lactose without symptoms Perino et al. 2009. Recommend the use of lactose-free or lactose-reduced dairy products and consider calcium and vitamin D supplementation if dietary intake is insufficient to maintain bone health, similar to advice given in related dietary conditions (e.g., coeliac disease) NICE NG20.
Advise patients to maintain a balanced diet ensuring adequate nutrient intake while avoiding unnecessary dietary restrictions that could lead to nutritional deficiencies Montalto et al. 2006. Suggest keeping a food and symptom diary to help identify specific lactose-containing foods that trigger symptoms and to monitor dietary adjustments Perino et al. 2009. If symptoms persist despite dietary changes, consider referral to a dietitian for tailored advice and to exclude other gastrointestinal conditions such as irritable bowel syndrome or coeliac disease NICE NG20,NICE CG61.
In summary, dietary management should be individualized, focusing on symptom relief through lactose restriction, ensuring nutritional adequacy, and supporting patient education on lactose intolerance and suitable alternatives Montalto et al. 2006Perino et al. 2009 NICE NG20.
Key References
- NG20 - Coeliac disease: recognition, assessment and management
- CG61 - Irritable bowel syndrome in adults: diagnosis and management
- CG99 - Constipation in children and young people: diagnosis and management
- CG49 - Faecal incontinence in adults: management
- (Montalto et al., 2006): Management and treatment of lactose malabsorption.
- (Perino et al., 2009): Lactose intolerance: a non-allergic disorder often managed by allergologists.