Allergic Constipation: Association with Infantile Milk Allergy

Effects of Polymeric Formula vs Elemental Formula in Neonatal Piglets With Short Bowel Syndrome

“…38 In developing humans, diarrhea is a common GI symptom of hypersensitivity to cow's milk, and it has been suggested, although not proven, that this allergic phenomenon is more common in bowel-resected infants. 15,39 Although previous piglet and rat studies have shown that the polymeric formula is superior to the elemental formula for intestinal growth and adaptation postresection, these animal models were similar to JI piglets in this study, having an intact ileum. 20, 21 We would argue that the JI model is readily adaptable because the ileum is the primary site for GLP-2 production.…”

“…This difference was not found in piglets with ileum preserved (JI) or in sham piglets. Diet was not 17) 123.1 ± 12.6 (n = 9) 134.9 ± 21.0 (n = 8) .627 Sham (n = 15) 144 Table 2 and Figure 1). All the sham piglets weaned off PN before the end of the trial, regardless of formula types.…”

“…However, this is often difficult, particularly in preterm infants with poor enteral tolerance and risk of developing other conditions, such as protein allergy. 15 Therefore, in the clinical management of intestinal failure, elemental formula is often recommended. 16,17 In children with SBS, no difference between intact protein and an amino acid diet in intestinal permeability, weight gain, energy, and nitrogen absorption has been shown.…”

The milk of human constipation

“…[2][3][4] These studies, by their titles if not their content, imply that an adverse immunologic reaction to cow's milk protein induces a physiologic alteration in waste processing or elimination that results in constipation in some children. Purported evidence for the immune response to milk protein was generally more common in subjects responsive to milk elimination and included macroscopic lymphoid hyperplasia at endoscopy, an increase in cd + T lymphocytes in terminal ileal biopsies, increased peripheral eosinophil counts, increased Ig (immunoglobulin) G to b-lactoglobulin, elevated serum IgE levels, increased milk specific IgE by radioallergosorbent test, or increased inflammatory cells in the lamina propria of the colonic mucosa on biopsy.…”

“…1 We know that the incidence of cholelithiasis in patients with SCD increases with age, reaching >50% in young adults. [2][3][4] The mean number of hospitalizations and ambulatory visits for children with SCD and cholelithiasis is nearly twice that of children with SCD without cholelithiasis. 2 In addition, the potential complications arising during the course of medical observation of cholelithiasis seem to exceed the risks associated with laparoscopic cholecystectomy.…”