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Gastroesophageal reflux disease, colic and constipation in infants with food allergy

Heine, Ralf G

Current Opinion in Allergy & Clinical Immunology:
doi: 10.1097/01.all.0000225164.06016.5d
Food allergy
Abstract

Purpose of review: This review assesses the role of food allergy in the pathophysiology of gastroesophageal reflux disease, colic and constipation in infancy.

Recent findings: Frequent regurgitation, persistent crying and constipation are common clinical problems in infancy. A subgroup of infants with these conditions may respond to hypoallergenic diets, but only few randomized clinical trials have been conducted. Skin prick testing and food-specific antibody levels are usually not elevated in these infants, whereas atopy patch testing may diagnostic. The mechanisms by which cow's milk and other food allergens induce gastrointestinal motility disorders are not understood. Apart from cell-mediated reactions, non-immunological effects of food constituents on gastrointestinal motility and gut microbiota may be involved in the pathogenesis. In the absence of reliable diagnostic tests, dietary elimination and re-challenge are usually required to confirm food allergy. A trial of amino acid-based formula or an oligoantigenic maternal elimination diet may be indicated in infants who have failed conventional medical treatment.

Summary: Food allergy may contribute to gastroesophageal reflux disease, colic or constipation in infancy. Infants with these conditions often respond to hypoallergenic formula or a maternal elimination diet. Further research is needed to define the mechanisms and clinical markers of gastrointestinal food allergy in infancy.

Author Information

Departments of Allergy and Gastroenterology & Clinical Nutrition, Royal Children's Hospital, and Department of Paediatrics, University of Melbourne, Melbourne, Australia

Correspondence to: Dr Ralf G. Heine, MD FRACP, Department of Gastroenterology & Clinical Nutrition, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia Tel: +61 3 9345 5060; fax: +61 3 9345 6240; e-mail: ralf.heine@rch.org.au

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