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Cow's milk protein intolerance and chronic constipation in children
Author(s) -
Daher Silvia,
Tahan Soraia,
Solé Dirceu,
Naspitz Charles K.,
Da Silva Patrício Francy Reis,
Neto Ulysses Fagundes,
De Morais Mauro Batista
Publication year - 2001
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1034/j.1399-3038.2001.0o057.x
Subject(s) - medicine , immunoglobulin e , radioallergosorbent test , milk allergy , constipation , allergy , chronic constipation , elimination diet , gastroenterology , casein , food allergy , immunology , antibody , food science , chemistry
Cow's milk protein (CMP) allergy was investigated in 25 children (age‐range 3 months to 11 years) with chronic constipation. A diagnosis of constipation was made on the basis of a history of painful elimination of hard stools for at least 1 month, whether or not associated with a reduced frequency of stools or soiling. The children were evaluated using clinical parameters and the following laboratory tests: total serum immunoglobulin E (IgE); specific IgE (radioallergosorbent test [RAST]) for whole cow's milk, α‐lactoalbumin, β‐lactoglobulin, and a food group; and skin‐prick tests with whole milk, α‐lactoalbumin, β‐lactoglobulin, and casein. Following the evaluation, the children were submitted to a CMP‐free diet for a period of 4 weeks. In seven patients (28%), constipation disappeared during the CMP‐free diet and reappeared within 48–72 h following challenge with cow's milk. In two infants a rectal biopsy revealed allergic colitis and they therefore did not undergo the challenge. High serum levels of total IgE were observed in five of the children who showed a clinical improvement (71%), a positive skin‐test in two (29%), and detectable specific IgE in two (29%). These results suggest that CMP allergy or intolerance should be considered as a cause of chronic refractory constipation in children, although the underlying mechanism still require further investigation.