Gastro-intestinal manifestations of cows milk protein allergy and gastro-intestinal motility
Acta Pediatrica, 08/08/2012
Vandenplas Y et al. – As long as there are no objective diagnostic tools to separate gastro–oesophageal reflux (GER) from Cow’s milk protein allergy (CMPA), the physician has two options: first treat the most likely diagnosis, and switch if after 2–4 weeks there is no improvement, or treat both conditions with one intervention, what will not result in a diagnosis.
- Cow’s milk protein allergy (CMPA) may cause gastrointestinal motility disorders.
- Symptoms of both conditions overlap and diagnostic tests do not reliably differentiate between both.
- A decrease of symptoms with an extensive hydrolysate and relapse during challenge is not a proof of allergy, since hydrolysates enhance gastric emptying, a pathophysiologic mechanism of gastro–oesophageal reflux (GER).
- Thickened formula reduces regurgitation, and failure to do so suggests CMPA.
- A thickened extensive hydrolysate may induce more rapid improvement, but does not always differentiate between CMPA and GER.