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Cow's-milk-free diet as a therapeutic option in childhood chronic constipation.

Abstract

OBJECTIVES

It has been reported that a number of children with constipation respond to a diet free of cow's-milk (CM) proteins, although evidence is lacking to support an immunoglobulin E-mediated mechanism.

PATIENTS AND METHODS

We performed an open-label crossover study comparing CM and rice milk in 69 children who fulfilled Rome III criteria for chronic constipation. Clinical, physical, and immunologic parameters of patients who responded (R) and who did not respond (NR) to a CM-free diet were compared.

RESULTS

Thirty-five of the 69 children (51%) improved during the first CM-free diet phase, 8 of these did not develop constipation when CM was reintroduced, and 27 children (39%) developed constipation during the CM challenge and improved during the second CM-free diet phase (R group). Thirty-four children (49%) did not improve during the first CM-free diet phase (NR group). Bowel movements per week among R children significantly increased compared with NR children (R: 2.8-7.7 vs NR: 2.6-2.7) (P < 0.001). Seventy-eight percent of the children with developmental delay responded to the CM-free diet (P = 0.007). No significant statistical difference was found between the R and NR children in terms of fiber and milk consumption; atopic or allergic history; full-blood eosinophil count and percentage, and lymphocyte populations; immunoglobulins, immunoglobulin (Ig)G subclasses, total IgE; and serum-specific immunoglobulin E for CM proteins.

CONCLUSIONS

A clear association between CM consumption and constipation has been found in more than one third of children. However, analytical parameters do not demonstrate an immunoglobulin E-mediated immunologic mechanism.

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  • Authors+Show Affiliations

    ,

    Pediatric Gastroenterology Unit, Hospital de Cruces, Bilbao, Spain. iirastorza@osakidetza.net

    , , ,

    Source

    MeSH

    Animals
    Child
    Child, Preschool
    Chronic Disease
    Constipation
    Cross-Over Studies
    Defecation
    Developmental Disabilities
    Female
    Humans
    Infant
    Logistic Models
    Male
    Milk
    Milk Hypersensitivity

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    20453672

    Citation

    Irastorza, Inaki, et al. "Cow's-milk-free Diet as a Therapeutic Option in Childhood Chronic Constipation." Journal of Pediatric Gastroenterology and Nutrition, vol. 51, no. 2, 2010, pp. 171-6.
    Irastorza I, Ibañez B, Delgado-Sanzonetti L, et al. Cow's-milk-free diet as a therapeutic option in childhood chronic constipation. J Pediatr Gastroenterol Nutr. 2010;51(2):171-6.
    Irastorza, I., Ibañez, B., Delgado-Sanzonetti, L., Maruri, N., & Vitoria, J. C. (2010). Cow's-milk-free diet as a therapeutic option in childhood chronic constipation. Journal of Pediatric Gastroenterology and Nutrition, 51(2), pp. 171-6. doi:10.1097/MPG.0b013e3181cd2653.
    Irastorza I, et al. Cow's-milk-free Diet as a Therapeutic Option in Childhood Chronic Constipation. J Pediatr Gastroenterol Nutr. 2010;51(2):171-6. PubMed PMID: 20453672.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cow's-milk-free diet as a therapeutic option in childhood chronic constipation. AU - Irastorza,Inaki, AU - Ibañez,Berta, AU - Delgado-Sanzonetti,Lissette, AU - Maruri,Natalia, AU - Vitoria,Juan Carlos, PY - 2010/5/11/entrez PY - 2010/5/11/pubmed PY - 2011/2/16/medline SP - 171 EP - 6 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 51 IS - 2 N2 - OBJECTIVES: It has been reported that a number of children with constipation respond to a diet free of cow's-milk (CM) proteins, although evidence is lacking to support an immunoglobulin E-mediated mechanism. PATIENTS AND METHODS: We performed an open-label crossover study comparing CM and rice milk in 69 children who fulfilled Rome III criteria for chronic constipation. Clinical, physical, and immunologic parameters of patients who responded (R) and who did not respond (NR) to a CM-free diet were compared. RESULTS: Thirty-five of the 69 children (51%) improved during the first CM-free diet phase, 8 of these did not develop constipation when CM was reintroduced, and 27 children (39%) developed constipation during the CM challenge and improved during the second CM-free diet phase (R group). Thirty-four children (49%) did not improve during the first CM-free diet phase (NR group). Bowel movements per week among R children significantly increased compared with NR children (R: 2.8-7.7 vs NR: 2.6-2.7) (P < 0.001). Seventy-eight percent of the children with developmental delay responded to the CM-free diet (P = 0.007). No significant statistical difference was found between the R and NR children in terms of fiber and milk consumption; atopic or allergic history; full-blood eosinophil count and percentage, and lymphocyte populations; immunoglobulins, immunoglobulin (Ig)G subclasses, total IgE; and serum-specific immunoglobulin E for CM proteins. CONCLUSIONS: A clear association between CM consumption and constipation has been found in more than one third of children. However, analytical parameters do not demonstrate an immunoglobulin E-mediated immunologic mechanism. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/20453672/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=20453672 DB - PRIME DP - Unbound Medicine ER -