Cow's milk protein intolerance and childhood constipation - Letter to the Editor

Author: William Mora
Date: Sept 15, 2003

TO THE EDITOR: In the March 1, 2003 issue of American Family Physician, the department "Clinical Evidence" (1) addressed the effects of various treatments for childhood constipation. The author only briefly touches on the factor of dietary factors by stating that there are "no randomized controlled trials on the effects of increasing dietary fiber in children."

In my experience, intolerance of cow's milk is a significant cause of childhood constipation. A popular pediatric textbook (2) lists excessive milk intake as a cause of constipation in children. A double-blind study (3) of 65 children with chronic constipation who failed to respond to laxatives showed resolution of the constipation in 66 percent of the subjects while on soy milk.

REFERENCES

(1.) Rubin GP. Childhood constipation. [Clin Evidence] Am Fam Physician 2003;67:1041-2.

(2.) Sondheimer JM. Gastrointestinal tract. In: Hay WW. Current pediatric diagnosis & treatment. 15th ed. Norwalk, Conn: Appleton & Lange, 2001:561.

(3.) Iacono G, Cavataio F, Montalto G, Florena A, Tumminello M, Soresi M, et al. Intolerance of cow's milk and chronic constipation in children. N Engl J Med 1998;339:1100-4.

WILLIAM MORA, M.D.

3301 Alta Arden, Ste. 3

Sacramento, CA 95825

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