Influence of cow's milk protein allergy on the diagnosis of functional gastrointestinal diseases based on the Rome IV standard in infants and young children
FENG Bo-Wen1,2, FU Si-Mao1,2, ZHANG Quan-Shan2, LOGN Xiao-Ling2, XIE Guang-Qing2, REN Wei2, LIANG Zhan-Tu2, YANG Zhu-Ling2, CHEN Ang2
Third Clinical Medical School of Southern Medical University, Zhongshan, Guangdong 528400, China
Abstract:Objective To study the influence of cow's milk protein allergy (CMPA) on the diagnosis of functional gastrointestinal diseases (FGID) based on the Rome IV standard in infants and young children.Methods A total of 84 children aged 1 month to 3 years who were diagnosed with CMPA were enrolled as the case group, and 84 infants and young children who underwent physical examination and had no CMPA were enrolled as the control group. The pediatricians specializing in gastroenterology asked parents using a questionnaire for the diagnosis of FGID based on the Rome IV standard to assess clinical symptoms and to diagnose FGID.Results The case group had a significantly higher incidence rate of a family history of allergies than the control group (P<0.05). In the case group, 38 (45%) met the Rome IV standard for the diagnosis of FGID, while in the control group, 13 (15%) met this standard (P<0.05). According to the Rome IV standard for FGID, the case group had significantly higher diagnostic rates of reflex, functional diarrhea, difficult defecation, and functional constipation than the control group (P<0.05). The children who were diagnosed with FIGD in the control group were given conventional treatment, and those in the case group were asked to avoid the intake of cow's milk protein in addition to the conventional treatment. After 3 months of treatment, the case group had a significantly higher response rate to the treatment than the control group (P<0.05).Conclusions In infants and young children, CMPA has great influence on the diagnosis of FGID based on the Rome IV standard. The possibility of CMPA should be considered during the diagnosis of FGID.
FENG Bo-Wen,FU Si-Mao,ZHANG Quan-Shan et al. Influence of cow's milk protein allergy on the diagnosis of functional gastrointestinal diseases based on the Rome IV standard in infants and young children[J]. CJCP, 2018, 20(1): 56-59.
Saps M, Dhroove G, Chogle A. Henoch-Schonlein purpura leads to functional gastrointestinal disorders[J]. Dig Dis Sci, 2011, 56(6):1789-1793.
[8]
Klooker TK, Braak B, Painter RC, et al. Exposure to severe wartime conditions in early life is associated with an increased risk of irritable bowel syndrome:a population-based cohort study[J]. Am J Gastroenterol, 2009, 104(9):2250-2256.
Siah KTH, Gong X, Yang XJ, et al. Rome Foundation-Asian working team report:Asian functional gastrointestinal disorder symptom clusters[J]. Gut, 2017 Jun 7. pii:gutjnl-2016-312852. doi:10.1136/gutjnl-2016-312852.[Epub ahead of print].