Impaired gastric function in children with cow's milk intolerance

Area of Science:

• Pediatric Gastroenterology
• Clinical Nutrition
• Digestive Physiology

Background:

• Cow's milk intolerance (CMI) in infants can lead to malabsorption.
• Gastric acid secretion and gastrin levels are crucial for digestion and may be affected by CMI.
• Subtle gastrointestinal changes are often observed in infants with CMI.

Purpose of the Study:

• To investigate basal and maximal gastric acid secretion and fasting serum gastrin levels in infants with CMI.
• To assess the impact of CMI on gastric physiology.
• To evaluate the reversibility of these physiological changes upon dietary intervention.

Main Methods:

• Studied eight infants diagnosed with CMI.
• Measured basal and maximal gastric acid secretion.
• Assessed fasting serum gastrin levels and performed jejunal and gastric biopsies.

Main Results:

• Infants with CMI exhibited significantly decreased maximal gastric acid secretion (85 +/- 78 mumol/h/kg) compared to controls (233 +/- 66 mumol/h/kg).
• Fasting serum gastrin levels were elevated in infants with CMI (104 +/- 116 pmol/l) versus controls (37 +/- 10 pmol/l).
• Gastric biopsies revealed epithelial degeneration and inflammation, particularly in the antrum, in two out of three patients.

Conclusions:

• CMI is associated with impaired gastric acid production and altered gastrin levels in infants.
• Dietary management using human or soy milk effectively normalized gastric acid secretion within six months.
• These findings suggest that the gastric physiological disturbances in CMI are reversible with appropriate nutritional management.