Multiple food hypersensitivity as a cause of refractory chronic constipation in adults
Open Access
- 1 January 2006
- journal article
- case report
- Published by Taylor & Francis Ltd in Scandinavian Journal of Gastroenterology
- Vol. 41 (4), 498-504
- https://doi.org/10.1080/00365520500367400
Abstract
Chronic constipation that is unresponsive to laxative treatment is a severe illness, but children unresponsive to laxatives have been successfully treated with an elimination diet. We report the first cases of refractory chronic constipation caused by food hypersensitivity in adults. Four patients with refractory constipation who were unresponsive to high doses of laxatives were put on an oligo-antigenic diet and underwent successive double-blind, placebo-controlled, food challenges (DBPFC). Routine laboratory tests, immunological assays, colonoscopy, esophago-gastroduodenoscopy and rectal and duodenal histology were performed. While on an elimination diet, bowel habits normalized in all patients and a DBPFC challenge triggered the reappearance of constipation. In comparison with another 13 patients with refractory constipation unresponsive to the elimination diet, observed over the same period, the patients with food-hypersensitivity-related constipation had the following characteristics: longer duration of illness (ppppp<0.03). The duodenal and rectal mucosa histology showed lymphocyte and eosinophil infiltration, and the duodenal villi were flattened in two cases. In adult patients, refractory chronic constipation may be caused by food hypersensitivity and an elimination diet is effective in these subjects.Keywords
This publication has 27 references indexed in Scilit:
- Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trialGut, 2004
- Persistent cow's milk protein intolerance in infants: the changing faces of the same diseaseClinical and Experimental Allergy, 1998
- The immunomodulation of enteric neuromuscular function: Implications for motility and inflammatory disordersGastroenterology, 1996
- Isolated rice intolerance: Clinical and immunologic characteristics in four infantsThe Journal of Pediatrics, 1996
- THE EPIDEMIOLOGY OF FUNCTIONAL GASTROINTESTINAL DISORDERS IN NORTH AMERICAGastroenterology Clinics of North America, 1996
- Chronic constipation as a symptom of cow milk allergyThe Journal of Pediatrics, 1995
- U. S. Householder survey of functional gastrointestinal disordersDigestive Diseases and Sciences, 1993
- Multiple Food AllergyJournal of Pediatric Gastroenterology and Nutrition, 1993
- Immunologic and Absorptive Tests in Celiac Disease: Can They Replace Intestinal Biopsies?Scandinavian Journal of Gastroenterology, 1993
- Severity and Extent of Upper Small Bowel Mucosal Damage in Cowʼs Milk Protein-Sensitive EnteropathyJournal of Pediatric Gastroenterology and Nutrition, 1988