Linking IgE-mediated CMPA to functional gastrointestinal disorders.

Area of Science:

• Pediatric Gastroenterology
• Allergy and Immunology

Background:

• Cow's milk protein allergy (CMPA) is recognized as a potential factor in pediatric functional gastrointestinal disorders (FGID).
• Existing literature suggests CMPA may predispose children to or coexist with FGID.

Purpose of the Study:

• To determine if infant CMPA diagnosis is a long-term risk factor for FGID.
• To compare FGID development between IgE-mediated and non-IgE-mediated CMPA.
• To investigate differences in FGID prevalence based on CMPA type.

Main Methods:

• A case-control study involving 500 children aged 4-18 years.
• 250 participants with a history of infant CMPA diagnosis and 250 age-matched controls without CMPA.
• Parents completed questionnaires based on Rome IV criteria to assess FGID.

Main Results:

• Overall FGID frequency was similar between CMPA patients (28%) and controls (30.4%).
• Functional abdominal pain-not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS), and non-retentive fecal incontinence (NRFI) were more prevalent in children without CMPA.
• Functional dyspepsia (FD), FAP-NOS, and IBS were significantly more common in patients with IgE-mediated CMPA compared to non-IgE-mediated CMPA.

Conclusions:

• Long-term FGID development was not elevated in children with a history of CMPA.
• IgE-mediated CMPA was associated with increased incidence of FD, FAP-NOS, and IBS.
• Subclinical CMPA may persist in individuals with IgE-mediated CMPA, contributing to FGID symptoms.