Iranian Journal of Pediatrics

Published by: Kowsar

Allergy in Children with Functional Constipation and Irritable Bowel Syndrome

Carlo Caffarelli 1 , * , Dora Di Mauro 1 , Marilena Garrubba 1 and Carla Mastrorilli 1
Authors Information
1 Clinica Pediatrica, Dipartimento di Medicina Clinica e Sperimentale, University of Parma, Parma, Italy
Article information
  • Iranian Journal of Pediatrics: December 2016, 26 (6); e5206
  • Published Online: August 3, 2016
  • Article Type: Review Article
  • Received: December 30, 2015
  • Accepted: June 21, 2016
  • DOI: 10.5812/ijp.5206

To Cite: Caffarelli C, Mauro D D, Garrubba M, Mastrorilli C. Allergy in Children with Functional Constipation and Irritable Bowel Syndrome, Iran J Pediatr. 2016 ; 26(6):e5206. doi: 10.5812/ijp.5206.

Copyright © 2016, Growth & Development Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Context
2. Evidence Acquisition
3. Results
4. Conclusions
  • 1. Loening-Baucke V. Prevalence, symptoms and outcome of constipation in infants and toddlers. J Pediatr. 2005; 146(3): 359-63[DOI][PubMed]
  • 2. Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014; 6: 71-80[DOI][PubMed]
  • 3. Rome F. Guidelines--Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders. J Gastrointestin Liver Dis. 2006; 15(3): 307-12[PubMed]
  • 4. Drossman DA, Dumitrascu DL. Rome III: New standard for functional gastrointestinal disorders. J Gastrointestin Liver Dis. 2006; 15(3): 237-41[PubMed]
  • 5. Shah N, Lindley K, Milla P. Cow's milk and chronic constipation in children. N Engl J Med. 1999; 340(11): 891-2[PubMed]
  • 6. Scaillon M, Cadranel S. Food allergy and constipation in childhood: how functional is it? Eur J Gastroenterol Hepatol. 2006; 18(2): 125-8[PubMed]
  • 7. Barau E, Dupont C. Modifications of intestinal permeability during food provocation procedures in pediatric irritable bowel syndrome. J Pediatr Gastroenterol Nutr. 1990; 11(1): 72-7[PubMed]
  • 8. Shulman RJ, Eakin MN, Czyzewski DI, Jarrett M, Ou CN. Increased gastrointestinal permeability and gut inflammation in children with functional abdominal pain and irritable bowel syndrome. J Pediatr. 2008; 153(5): 646-50[DOI][PubMed]
  • 9. Walker MM, Powell N, Talley NJ. Atopy and the gastrointestinal tract--a review of a common association in unexplained gastrointestinal disease. Expert Rev Gastroenterol Hepatol. 2014; 8(3): 289-99[DOI][PubMed]
  • 10. Ford AC, Talley NJ. Mucosal inflammation as a potential etiological factor in irritable bowel syndrome: a systematic review. J Gastroenterol. 2011; 46(4): 421-31[DOI][PubMed]
  • 11. Jones MP, Walker MM, Ford AC, Talley NJ. The overlap of atopy and functional gastrointestinal disorders among 23,471 patients in primary care. Aliment Pharmacol Ther. 2014; 40(4): 382-91[DOI][PubMed]
  • 12. Collins SM, Piche T, Rampal P. The putative role of inflammation in the irritable bowel syndrome. Gut. 2001; 49(6): 743-5[PubMed]
  • 13. Borrelli O, Barbara G, Di Nardo G, Cremon C, Lucarelli S, Frediani T, et al. Neuroimmune interaction and anorectal motility in children with food allergy-related chronic constipation. Am J Gastroenterol. 2009; 104(2): 454-63[DOI][PubMed]
  • 14. Daher S, Tahan S, Sole D, Naspitz CK, Da Silva Patricio FR, Neto UF, et al. Cow's milk protein intolerance and chronic constipation in children. Pediatr Allergy Immunol. 2001; 12(6): 339-42[PubMed]
  • 15. Turunen S, Karttunen TJ, Kokkonen J. Lymphoid nodular hyperplasia and cow's milk hypersensitivity in children with chronic constipation. J Pediatr. 2004; 145(5): 606-11[DOI][PubMed]
  • 16. Iacono G, Bonventre S, Scalici C, Maresi E, Di Prima L, Soresi M, et al. Food intolerance and chronic constipation: manometry and histology study. Eur J Gastroenterol Hepatol. 2006; 18(2): 143-50[PubMed]
  • 17. Bischoff S, Crowe SE. Gastrointestinal food allergy: new insights into pathophysiology and clinical perspectives. Gastroenterology. 2005; 128(4): 1089-113[PubMed]
  • 18. Walker MM, Talley NJ, Prabhakar M, Pennaneac'h CJ, Aro P, Ronkainen J, et al. Duodenal mastocytosis, eosinophilia and intraepithelial lymphocytosis as possible disease markers in the irritable bowel syndrome and functional dyspepsia. Aliment Pharmacol Ther. 2009; 29(7): 765-73[DOI][PubMed]
  • 19. Barbara G, Stanghellini V, De Giorgio R, Corinaldesi R. Functional gastrointestinal disorders and mast cells: implications for therapy. Neurogastroenterol Motil. 2006; 18(1): 6-17[DOI][PubMed]
  • 20. Collins SM. The immunomodulation of enteric neuromuscular function: implications for motility and inflammatory disorders. Gastroenterology. 1996; 111(6): 1683-99[PubMed]
  • 21. Iacono G, Carroccio A, Cavataio F, Montalto G, Cantarero MD, Notarbartolo A. Chronic constipation as a symptom of cow milk allergy. J Pediatr. 1995; 126(1): 34-9[PubMed]
  • 22. White AM, Stevens WH, Upton AR, O'Byrne PM, Collins SM. Airway responsiveness to inhaled methacholine in patients with irritable bowel syndrome. Gastroenterology. 1991; 100(1): 68-74[PubMed]
  • 23. Yazar A, Atis S, Konca K, Pata C, Akbay E, Calikoglu M, et al. Respiratory symptoms and pulmonary functional changes in patients with irritable bowel syndrome. Am J Gastroenterol. 2001; 96(5): 1511-6[DOI][PubMed]
  • 24. Huerta C, Garcia Rodriguez LA, Wallander MA, Johansson S. Risk of irritable bowel syndrome among asthma patients. Pharmacoepidemiol Drug Saf. 2002; 11(1): 31-5[DOI][PubMed]
  • 25. Leander M, Cronqvist A, Janson C, Uddenfeldt M, Rask-Andersen A. Health-related quality of life predicts onset of asthma in a longitudinal population study. Respir Med. 2009; 103(2): 194-200[DOI][PubMed]
  • 26. Kiefte-de Jong JC, Lebon A, Jaddoe VW, Hofman A, de Jongste JC, Moll HA. Is there an association between wheezing and constipation in preschool children? Explanations from a longitudinal birth cohort. BMJ Open. 2011; 1(2): 237[DOI][PubMed]
  • 27. Caffarelli C, Coscia A, Baldi F, Borghi A, Capra L, Cazzato S, et al. Characterization of irritable bowel syndrome and constipation in children with allergic diseases. Eur J Pediatr. 2007; 166(12): 1245-52[DOI][PubMed]
  • 28. Simeone D, Miele E, Boccia G, Marino A, Troncone R, Staiano A. Prevalence of atopy in children with chronic constipation. Arch Dis Child. 2008; 93(12): 1044-7[DOI][PubMed]
  • 29. Buisseret PD. Common manifestations of cow's milk allergy in children. Lancet. 1978; 1(8059): 304-5[PubMed]
  • 30. 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(16): 1100-4[DOI][PubMed]
  • 31. Dehghani SM, Ahmadpour B, Haghighat M, Kashef S, Imanieh MH, Soleimani M. The Role of Cow's Milk Allergy in Pediatric Chronic Constipation: A Randomized Clinical Trial. Iran J Pediatr. 2012; 22(4): 468-74[PubMed]
  • 32. El-Hodhod MA, Younis NT, Zaitoun YA, Daoud SD. Cow's milk allergy related pediatric constipation: appropriate time of milk tolerance. Pediatr Allergy Immunol. 2010; 21(2 Pt 2): 407-12[DOI][PubMed]
  • 33. Irastorza I, Ibanez B, Delgado-Sanzonetti L, Maruri N, Vitoria JC. Cow's-milk-free diet as a therapeutic option in childhood chronic constipation. J Pediatr Gastroenterol Nutr. 2010; 51(2): 171-6[DOI][PubMed]
  • 34. Syrigou EI, Pitsios C, Panagiotou I, Chouliaras G, Kitsiou S, Kanariou M, et al. Food allergy-related paediatric constipation: the usefulness of atopy patch test. Eur J Pediatr. 2011; 170(9): 1173-8[DOI][PubMed]
  • 35. Caglayan Sozmen S, Povesi Dascola C, Gioia E, Mastrorilli C, Rizzuti L, Caffarelli C. Diagnostic accuracy of patch test in children with food allergy. Pediatr Allergy Immunol. 2015; 26(5): 416-22[DOI][PubMed]
  • 36. Loening-Baucke V. Controversies in the management of chronic constipation. J Pediatr Gastroenterol Nutr. 2001; 32 Suppl 1-9[PubMed]
  • 37. Bergmann MM, Caubet JC, McLin V, Belli DC, Schappi MG, Eigenmann PA. Common colic, gastroesophageal reflux and constipation in infants under 6 months of age do not necessitate an allergy work-up. Pediatr Allergy Immunol. 2014; 25(4): 410-2[DOI][PubMed]
  • 38. Constipation in children and young people - Diagnosis and management of idiopathic childhood constipation in primary and secondary care 2010;
  • 39. Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014; 58(2): 258-74[PubMed]
  • 40. Miceli Sopo S, Arena R, Greco M, Bergamini M, Monaco S. Constipation and cow's milk allergy: a review of the literature. Int Arch Allergy Immunol. 2014; 164(1): 40-5[DOI][PubMed]
  • 41. El-Matary W, Spray C, Sandhu B. Irritable bowel syndrome: the commonest cause of recurrent abdominal pain in children. Eur J Pediatr. 2004; 163(10): 584-8[DOI][PubMed]
  • 42. Carlson MJ, Moore CE, Tsai CM, Shulman RJ, Chumpitazi BP. Child and parent perceived food-induced gastrointestinal symptoms and quality of life in children with functional gastrointestinal disorders. J Acad Nutr Diet. 2014; 114(3): 403-13[DOI][PubMed]
  • 43. Monsbakken KW, Vandvik PO, Farup PG. Perceived food intolerance in subjects with irritable bowel syndrome-- etiology, prevalence and consequences. Eur J Clin Nutr. 2006; 60(5): 667-72[DOI][PubMed]
  • 44. Wilson K, Hill RJ. The role of food intolerance in functional gastrointestinal disorders in children. Aust Fam Physician. 2014; 43(10): 686-9[PubMed]
  • 45. Shepherd SJ, Parker FC, Muir JG, Gibson PR. Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence. Clin Gastroenterol Hepatol. 2008; 6(7): 765-71[DOI][PubMed]
  • 46. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014; 146(1): 67-75[DOI][PubMed]
  • 47. Gomara RE, Halata MS, Newman LJ, Bostwick HE, Berezin SH, Cukaj L, et al. Fructose intolerance in children presenting with abdominal pain. J Pediatr Gastroenterol Nutr. 2008; 47(3): 303-8[PubMed]
  • 48. Escobar MA, Lustig D, Pflugeisen BM, Amoroso PJ, Sherif D, Saeed R, et al. Fructose intolerance/malabsorption and recurrent abdominal pain in children. J Pediatr Gastroenterol Nutr. 2014; 58(4): 498-501[PubMed]
  • 49. Chumpitazi BP, Cope JL, Hollister EB, Tsai CM, McMeans AR, Luna RA, et al. Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome. Aliment Pharmacol Ther. 2015; 42(4): 418-27[DOI][PubMed]
  • 50. Ong DK, Mitchell SB, Barrett JS, Shepherd SJ, Irving PM, Biesiekierski JR, et al. Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol. 2010; 25(8): 1366-73[DOI][PubMed]
  • 51. Mullin GE, Shepherd SJ, Chander Roland B, Ireton-Jones C, Matarese LE. Irritable bowel syndrome: contemporary nutrition management strategies. JPEN J Parenter Enteral Nutr. 2014; 38(7): 781-99[DOI][PubMed]
  • 52. Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med. 2012; 10: 13[DOI][PubMed]
  • 53. Dearlove J, Dearlove B, Pearl K, Primavesi R. Dietary lactose and the child with abdominal pain. Br Med J (Clin Res Ed). 1983; 286(6382): 1936[PubMed]
  • 54. Lebenthal E, Rossi TM, Nord KS, Branski D. Recurrent abdominal pain and lactose absorption in children. Pediatrics. 1981; 67(6): 828-32[PubMed]
  • 55. Caffarelli C, Rico S, Rinaldi L, Povesi Dascola C, Terzi C, Bernasconi S. Blood pressure monitoring in children undergoing food challenge: association with anaphylaxis. Ann Allergy Asthma Immunol. 2012; 108(4): 285-6[DOI][PubMed]
  • 56. Giovannini M, D'Auria E, Caffarelli C, Verduci E, Barberi S, Indinnimeo L, et al. Nutritional management and follow up of infants and children with food allergy: Italian Society of Pediatric Nutrition/Italian Society of Pediatric Allergy and Immunology Task Force Position Statement. Ital J Pediatr. 2014; 40: 1[DOI][PubMed]
  • 57. Nimrouzi M, Sadeghpour O, Imanieh MH, Shams Ardekani M, Salehi A, Minaei MB, et al. Flixweed vs. Polyethylene Glycol in the Treatment of Childhood Functional Constipation: A Randomized Clinical Trial. Iran J Pediatr. 2015; 25(2): 425[DOI][PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments