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Food intolerance and chronic constipation: manometry and histology study
Giuseppe Iacono1, Sebastiano Bonventre, Calogero Scalici
1Department of Paediatric Gastroenterology, Di Cristina Hospital, Palermo, Italy.
European Journal of Gastroenterology & Hepatology
|January 6, 2006
Summary
Children with chronic constipation may have cows' milk intolerance (CMI). This study found CMI causes inflammation and altered bowel function, which resolves with diet, indicating food intolerance as a cause of constipation.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
- Digestive Health
Background:
- Chronic constipation in children is a common issue.
- Cows' milk intolerance (CMI) is a potential cause, but its mechanisms are unclear.
Purpose of the Study:
- To investigate the histological and manometric characteristics of children with constipation linked to food intolerance.
Main Methods:
- Thirty-six children with chronic constipation underwent dietary elimination and double-blind food challenges.
- Rectal biopsies and anorectal manometry were performed on all participants.
Main Results:
- 17 children had food intolerance (14 CMI, 3 multiple). Constipation resolved on diet and returned upon reintroduction of trigger foods.
- Food-intolerant children showed increased mucosal erosions, intraepithelial lymphocytes, and eosinophils.
- Reduced rectal mucus layer thickness, higher anal resting pressure, and lower critical volumes were observed in food-intolerant patients.
- Histological and manometric abnormalities normalized after dietary elimination.
Conclusions:
- Food intolerance-related constipation is associated with rectal inflammation (proctitis).
- Elevated anal resting pressure and a diminished rectal mucus layer appear to contribute to the development of constipation in these children.