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Friday, January 02, 2009

Constipation Not Linked to Dairy Allergy in Children

The Doctor NDTV site reported on a new study on chronic constipation.

The prevalence of allergies among children with chronic constipation is not significantly different from that of the general population and an allergy to cow's milk does not seem to be involved.

In several studies, chronic constipation in children has been reported as a clinical manifestation of cow's milk allergy. Allergic proctitis - an allergic reaction causing inflammation of the rectum, which can be accompanied by a frequent urge to defecate, bloody stools and other symptoms - has been suspected, but the response to eliminating cow's milk protein from the diet has been variable.

They took this from an article in the December 2008 issue of Archives of Disease in Childhood. D. Simone et al. 93(12):1044-1047, December 2008.

Prevalence of atopy in children with chronic constipation.
Objectives: To evaluate the prevalence of chronic constipation (CC) in unselected children, its association with atopy and the efficacy of a cow's milk protein (CMP) elimination diet on refractory constipation.

Study design: The study was conducted by six primary care paediatricians, serving a population of 5113 children aged from birth through to 12 years; only 2068 children were 6 months to 6 years. During a 3-month period, prevalence of CC was determined for the entire study population, ages 0-12 years. In the second part of the study, all patients aged 6 months to 6 years with CC, and age- and sex-matched controls, were evaluated for atopy and its association with CC. A questionnaire was completed including personal and family history of atopy and bowel-movement characteristics. Patients were tested for atopy by specific serum IgE and/or skin-prick tests. Constipated patients, refractory to osmotic laxatives, underwent a 4-week CMP elimination diet.

Results: 91 (1.8%) children had CC, and 69 (3.3%) of the 6 months to 6 years age group fell into the atopy study age range. All 69 constipated children (mean age 34.9 (18.0) months) and 69 controls completed the questionnaire. Twelve of the 69 constipated children (17.3%) and 13 out of the 69 control children (18.8%) had a diagnosis of atopy. Eleven out of 69 (15.9%) constipated children were refractory to constipation treatment, and three (27.3%) of these had atopy. The 4-week trial of dietary elimination did not result in improvement in any of these 11 children.

Conclusions: In our study group, prevalence of atopy among children with CC is similar to that in the general population. The level of refraction of CC does not seem to be related to cow's milk allergy.

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