To minimise symptoms and enhance short- and/or long-term management of lactose intolerance

To help patients recognise changing symptoms to guide and inform if, when and how to alter diet i.e. reintroduce higher lactose foods.

The TG will:

• know what lactose is and how to identify foods that contain/are likely to contain lactose
  • label reading advice provided
• know what the symptoms of lactose intolerance are, and that people can have varying and changeable tolerance levels
• understand the role of lactase in symptom control
• understand that intolerance is not an allergy
• know how to follow a low lactose diet and know how find their lactose tolerance to control their symptoms
• be aware of the dietary risks of restricting/eliminating lactose and be able to implement guidance to eliminate these risks
  • non-dairy calcium sources
  • ensuring sufficient vitamin B12 and protein intake

• NICE Guidelines: Irritable bowel syndrome in adults: diagnosis and management Clinical guideline [CG61]  2008, updated: April 2017.
• British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. 2021.
• British Dietetic Association systematic review and evidence based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update) Mckenzie, Y. A.; Thompson, J.; Gulia, P.; Lomer, M. C. E. Journal of Human Nutrition and Dietetics, October 2016, Vol.29(5), pp.576-592
• British Dietetic Association systematic review of systematic reviews and evidence-based practice guidelines for the use of probiotics in the management of irritable bowel syndrome in adults (2016 update), Mckenzie, Y. A.; Thompson, J.; Gulia, P.; Lomer, M. C. E. Journal of Human Nutrition and Dietetics, October 2016, Vol.29(5), pp.576-592
• Carbohydrates and Health, Scientific Advisory Committee on Nutrition, 2015.
• Lactose Intolerance in Adults: Biological Mechanism and Dietary Management, Deng, Yy; Misselwitz, B; Dai, N ; Fox, M, Nutrients, 2015 Sep, Vol.7(9), pp.8020-8035
• Misselwitz, B et al. Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management. Gut 2019;68:2080–2091.
• Ford, A.C et al. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Aliment Pharmacol Ther. 2018;48:1044-1060.
• Ceccherini, C et al. Evaluating the Efficacy of Probiotics in IBS Treatment Using a Systematic Review of Clinical Trials and Multi-Criteria Decision Analysis. Nutrients 2022, 14 (3), 2689.
• Francavilla, R et al. 2019. Clinical and Microbiological Effect of a Multispecies Probiotic Supplementation in Celiac Patients With Persistent IBS-type Symptoms: A Randomized, Double-Blind, Placebo-controlled, Multicenter Trial. Journal of Clinical Gastroenterology, 53 (3), e117-e125.
• Facioni, M. S. et al. Nutritional management of lactose intolerance: the importance of diet and food labelling. J Transl Med 18, 260 (2020).
• Corgneau, M. et al. Recent advances on lactose intolerance: tolerance thresholds and currently available answers. Crit Rev Food Sci Nutr. 2017 Oct 13;57:3344-3356.
• EFSA Scientific opinion on lactose thresholds in lactose interlace and galactosaemic. 2010.