I hate getting questions that I can't answer, but "it depends" is all-too-often the only real comment that I can make.
This was in an email I recently received:
After reading pretty much everything on your website and a lot of others, I still haven't found the answer to this question: How long after you stop consuming lactose does it clear your system and stop causing symptoms? Are there any residual effects and/or damage to the gut?
There is very little that's more individual than a lactose attack. It varies not just by person to person, but every single time you take in more lactose than you can digest. How much lactose you eat, whether it's part of a meal or whether it's mostly liquid, how much lactase may remain in your system, and how sensitive your intestines are all play a major role.
The symptoms may be mild or severe and may last for a short time or for quite a while.
You cannot damage the gut by having lactose. If you are particularly sensitive or also have Irritable Bowel Syndrome, your intestines may keep on spasming even after the lactose is gone. At that point taking an antidiarrheal drug to stop the spasming is a good idea. Don't take one right away thinking that you're stopping the symptoms. You'd just be keeping the lactose in you longer.
Extreme cases of lactose intolerance (LI), meaning times when someone keeps having milk despite the symptoms, can lead to dehydration from the water loss. That used to happen in the days before people knew what LI was. (If you didn't know that milk caused your problem you wouldn't think to stop having it.) I haven't heard of a case of dehydration in a very long time. Knowing all about LI is far too common in the U.S. This might be a concern in some other countries where understanding of LI is just beginning to reach our levels.
LI is uncomfortable but not dangerous. The sympotms will go away when the lactose is gone (and you make sure not take in more lactose). It just seems like forever.