Tags

Type your tag names separated by a space and hit enter

Gastrointestinal manifestations of cow's milk protein allergy and gastrointestinal motility.
Acta Paediatr 2012; 101(11):1105-9AP

Abstract

Cow's milk protein allergy (CMPA) may cause gastrointestinal motility disorders. Symptoms of both conditions overlap and diagnostic tests do not reliably differentiate between both. A decrease of symptoms with an extensive hydrolysate and relapse during challenge is not a proof of allergy, because hydrolysates enhance gastric emptying, a pathophysiologic mechanism of gastro-oesophageal reflux (GER). Thickened formula reduces regurgitation, and failure to do so suggests CMPA. A thickened extensive hydrolysate may induce more rapid improvement, but does not always differentiate between CMPA and GER. Different hypotheses are discussed: is the overlap between CMPA and functional disorders coincidence, or do both entities present with identical symptoms, or does the fact that symptoms are identical indicates that there is only one entity involved? Studies on the prevention of CMPA focused on 'at-risk families', and resulted in a decrease of CMPA and atopic dermatitis, but did not provide data on the incidence of GER.

CONCLUSION

As long as there are no objective diagnostic tools to separate GER from CMPA, the physician has two options: first treat the most likely diagnosis, and switch if after 2-4 weeks there is no improvement, or treat both conditions with one intervention, what will not result in a diagnosis.

Authors+Show Affiliations

UZ Brussel, Vrije Universiteit Brussel, Belgium. yvan.vandenplas@uzbrussel.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22882286

Citation

Vandenplas, Yvan, et al. "Gastrointestinal Manifestations of Cow's Milk Protein Allergy and Gastrointestinal Motility." Acta Paediatrica (Oslo, Norway : 1992), vol. 101, no. 11, 2012, pp. 1105-9.
Vandenplas Y, Gottrand F, Veereman-Wauters G, et al. Gastrointestinal manifestations of cow's milk protein allergy and gastrointestinal motility. Acta Paediatr. 2012;101(11):1105-9.
Vandenplas, Y., Gottrand, F., Veereman-Wauters, G., De Greef, E., Devreker, T., Hauser, B., ... Heymans, H. S. (2012). Gastrointestinal manifestations of cow's milk protein allergy and gastrointestinal motility. Acta Paediatrica (Oslo, Norway : 1992), 101(11), pp. 1105-9. doi:10.1111/j.1651-2227.2012.02808.x.
Vandenplas Y, et al. Gastrointestinal Manifestations of Cow's Milk Protein Allergy and Gastrointestinal Motility. Acta Paediatr. 2012;101(11):1105-9. PubMed PMID: 22882286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastrointestinal manifestations of cow's milk protein allergy and gastrointestinal motility. AU - Vandenplas,Yvan, AU - Gottrand,Frederic, AU - Veereman-Wauters,Gigi, AU - De Greef,Elisabeth, AU - Devreker,Thierry, AU - Hauser,Bruno, AU - Benninga,Marc, AU - Heymans,Hugo S A, Y1 - 2012/08/29/ PY - 2012/8/14/entrez PY - 2012/8/14/pubmed PY - 2013/3/8/medline SP - 1105 EP - 9 JF - Acta paediatrica (Oslo, Norway : 1992) JO - Acta Paediatr. VL - 101 IS - 11 N2 - UNLABELLED: Cow's milk protein allergy (CMPA) may cause gastrointestinal motility disorders. Symptoms of both conditions overlap and diagnostic tests do not reliably differentiate between both. A decrease of symptoms with an extensive hydrolysate and relapse during challenge is not a proof of allergy, because hydrolysates enhance gastric emptying, a pathophysiologic mechanism of gastro-oesophageal reflux (GER). Thickened formula reduces regurgitation, and failure to do so suggests CMPA. A thickened extensive hydrolysate may induce more rapid improvement, but does not always differentiate between CMPA and GER. Different hypotheses are discussed: is the overlap between CMPA and functional disorders coincidence, or do both entities present with identical symptoms, or does the fact that symptoms are identical indicates that there is only one entity involved? Studies on the prevention of CMPA focused on 'at-risk families', and resulted in a decrease of CMPA and atopic dermatitis, but did not provide data on the incidence of GER. CONCLUSION: As long as there are no objective diagnostic tools to separate GER from CMPA, the physician has two options: first treat the most likely diagnosis, and switch if after 2-4 weeks there is no improvement, or treat both conditions with one intervention, what will not result in a diagnosis. SN - 1651-2227 UR - https://www.unboundmedicine.com/medline/citation/22882286/Gastrointestinal_manifestations_of_cow's_milk_protein_allergy_and_gastrointestinal_motility_ L2 - https://doi.org/10.1111/j.1651-2227.2012.02808.x DB - PRIME DP - Unbound Medicine ER -