Food intolerance and chronic constipation: manometry and histology study

Abstract

Background Chronic constipation in children can be caused by cows' milk intolerance (CMI), but its pathogenesis is unknown.Aims To evaluate the histology and manometry pattern in patients with food intolerance-related constipation.Patients and methods Thirty-six consecutive children with chronic constipation were enrolled. All underwent an elimination diet and successive double-blind food challenge. All underwent rectal biopsy and anorectal manometry.Results A total of 14 patients were found to be suffering from CMI and three from multiple food intolerance. They had a normal stool frequency on elimination diet, whereas constipation recurred on food challenge. The patients with food intolerance showed a significantly higher frequency of erosions of the mucosa, and the number of intra-epithelial lymphocytes and eosinophils. The rectal mucous gel layer showed that the food-intolerant patients had a significantly lower thickness of mucous than the other subjects studied. Manometry showed a higher anal sphincter resting pressure and a lower critical volume in food intolerance patients than in the others suffering from constipation unrelated to food intolerance. Both histology and manometry abnormalities disappeared on the elimination diet.Conclusions Food intolerance-related constipation is characterized by proctitis. Increased anal resting pressure and a reduced mucous gel layer can be considered to be contributory factors in the pathogenesis of constipation. Eur

Determination of the Effect of the Elimination Diet Applied for Overweight and Obese People with Food Intolerance on Body Composition and Biochemical Parameters

“…There is a study, in which elimination diet was applied for children with constipation that did not respond to laxative therapy, and thus, all children, who participated in the research, were treated successfully and their bowel functions returned to normal. There are also other studies reporting successful results with elimination diet for people with constipation [47][48][49].…”

Fecal Assays Detect Hypersensitivity to Cow's Milk Protein and Gluten in Adults With Irritable Bowel Syndrome

“…3,4,[7][8][9] In fact, the relationship between FH and dismotility in pediatric patients has been clearly demonstrated. 20,[33][34][35] ECP might be as useful in FH patients as it is in patients with respiratory allergic diseases. 36 In our study, fecal ECP values were 2-fold higher in FH than in IBS patients or in healthy control subjects.…”

Oligo-Antigenic Diet in the Treatment of Chronic Anal Fissures. Evidence for a Relationship Between Food Hypersensitivity and Anal Fissures

“…In these patients, the anal resting pressure is higher than in subjects with chronic constipation, which was not due to FH, and it became normal on oligo-antigenic diet ( 16 ). Borrelli et al ( 17 ) demonstrated that mast cell density in the rectal mucosa correlates with anal motor abnormalities and the diet positively infl uenced this aspect.…”

“…One of the pathological mechanisms of constipation due to FH is the high resting anal pressure, which normalizes on elimination diet ( 16,17 ), thus demonstrating a relationship between the elimination diet and the resting anal pressure.…”