Diagnosis and management of food allergy‐induced constipation in young children—An EAACI position paper

Author:

Meyer Rosan12ORCID,Vandenplas Yvan3ORCID,Lozinsky Adriana Chebar4,Vieira Mario C.5,Berni Canani Roberto6,du Toit George78,Dupont Christophe9ORCID,Giovannini Mattia1011ORCID,Uysal Pinar12ORCID,Cavkaytar Ozlem13ORCID,Knibb Rebecca14ORCID,Fleischer David M.15,Nowak‐Wegrzyn Anna16,Venter Carina15ORCID

Affiliation:

1. Department of Nutrition and Dietetics University of Winchester Winchester UK

2. Department of Medicine KU Leuven Leuven Belgium

3. KidZ Health Castle UZ Brussel, Vrije Universiteit Brussel Brussel Belgium

4. Department of Allergy and Immune Disorders Murdoch Children's Research Institute Parkville Victoria Australia

5. Center for Pediatric Gastroenterology – Hospital Pequeno Príncipe Curitiba Brazil

6. Department of Translational Medical Science and ImmunoNutritionLab at CEINGE – Advanced Biotechnologies Research Center University of Naples “Federico II” Naples Italy

7. Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine King's College London London UK

8. Children's Allergy Service Evelina London Children's Hospital, Guy's and St Thomas' Hospital London UK

9. Department of Paediatric Gastroenterology Necker University Children Hospital Paris France

10. Allergy Unit Meyer Children's Hospital IRCCS Florence Italy

11. Department of Health Sciences University of Florence Florence Italy

12. Department of Allergy and Clinical Immunology Adnan Menderes University Aydin Turkey

13. Department of Pediatric Allergy and Immunology Istanbul Medeniyet University, Faculty of Medicine, Goztepe Prof Suleyman Yalcin City Hospital Istanbul Turkey

14. School of Psychology Aston University Birmingham UK

15. University of Colorado Denver School of Medicine, Children's Hospital Colorado Aurora Colorado USA

16. Icahn School of Medicine at Mount Sinai Jaffe Food Allergy Institute New York New York USA

Abstract

AbstractThe recognition of constipation as a possible non‐Immunoglobulin E (IgE)‐mediated allergic condition is challenging because functional constipation (unrelated to food allergies) is a common health problem with a reported worldwide prevalence rate of up to 32.2% in children. However, many studies in children report challenge proven cow's milk allergy and constipation as a primary symptom and have found that between 28% and 78% of children improve on a cow's milk elimination diet. Due to the paucity of data and a focus on IgE‐mediated allergy, not all food allergy guidelines list constipation as a symptom of food allergy. Yet, it is included in all cow's milk allergy guidelines available in English language. The Exploring Non‐IgE‐Mediated Allergy (ENIGMA) Task Force (TF) of the European Academy for Allergy and Clinical Immunology (EAACI) considers in this paper constipation in the context of failure of standard treatment and discuss the role of food allergens as culprit in constipation in children. This position paper used the Delphi approach in reaching consensus on both diagnosis and management, as currently published data are insufficient to support a systematic review.

Funder

European Academy of Allergy and Clinical Immunology

Publisher

Wiley

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