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Linking IgE-mediated CMPA to functional gastrointestinal disorders.

Nur Kevser Özyurt1, Merve Kişioğlu2, Burcu Güven3

  • 1Department of Pediatrics, Faculty of Medicine, Karadeniz Technical University, Üniversite Mahallesi, Farabi Cd. No:64, 61080, Trabzon, Turkey.

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Summary

Infancy cow's milk protein allergy (CMPA) did not increase long-term functional gastrointestinal disorder (FGID) risk. However, IgE-mediated CMPA was linked to higher rates of functional dyspepsia, functional abdominal pain, and irritable bowel syndrome.

Keywords:
Cow’s milk protein allergyFunctional gastrointestinal disordersPediatric

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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.