Still have persistent symptoms after starting a gluten free diet?

Most often this is due to inadvertent exposure to gluten, and it is often beneficial to have further dietetic evaluation to rule this out as a cause. Sometimes it is due to a secondary lactose intolerance which is temporary. Once the lining of the bowel and the villi have started to heal with institution of the gluten free diet, lactose intolerance should improve and a lactose free diet could be liberalized after a few months.