Chronic constipation as a symptom of cow milk allergy☆,☆☆,★
Section snippets
METHODS
The study group included all the patients with chronic constipation, aged < 3 years, referred to our pediatric gastroenterology clinic during the preceding 12 months. Two patients with mental retardation and one with Hirschsprung disease were excluded. Anorectal manometry and biopsy of the intestinal mucosa were also performed in two cases of suspected megacolon and megarectum (patients with marked abdominal distention and clinical signs of malnutrition). Twenty-seven infants (15 boys) were
RESULTS
During the first month of the CMP-free diet there was a significant improvement in symptoms in 21 patients: the frequency of stools significantly increased, feces were soft, and none of the infants had any discomfort when passing stools. These improvements were rapid; in all patients the bowel frequency became normal within the first 3 days of the CMP-free diet. In the remaining six study patients, the CMP-free diet did not lead to any changes, either in the number of stools or in the symptoms
DISCUSSION
These data indicate that some cases of “idiopathic” constipation were due to CMPA; 21 of 27 of the patients showed rapid improvement. Symptoms completely regressed when a CMP-free diet was used, and there was a clinical relapse during two subsequent cow milk challenges. The possibility that CMPA might be manifested only by the presence of constipation has rarely been reported; 8, 9 apart from single case reports, the presence of constipation as a symptom of CMPA has been reported only in
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From the Cattedra di Patologia Medica II, Universitá di Palermo Ospedale Pediatrico G. Di Cristina, Palermo, Italy.
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Reprint requests: Antonio Carroccio, MD, via Coffaro No. 25, 90124 Palermo, Italy.
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