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

Rosan Meyer; Yvan Vandenplas; Adriana Chebar Lozinsky; Mario C. Vieira; Roberto Berni Canani; George du Toit; Christophe Dupont; Mattia Giovannini; Pinar Uysal; Ozlem Cavkaytar; Rebecca Knibb; David M. Fleischer; Anna Nowak-Wegrzyn; Carina Venter

doi:10.1111/pai.14163

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

Rosan Meyer, Yvan Vandenplas, Adriana Chebar Lozinsky, Mario C. Vieira, Roberto Berni Canani, George du Toit, Christophe Dupont, Mattia Giovannini, Pinar Uysal, Ozlem Cavkaytar, Rebecca Knibb, David M. Fleischer, Anna Nowak-Wegrzyn, Carina Venter

School of Psychology

Research output: Contribution to journal › Review article › peer-review

Abstract

The 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.

Original language	English
Article number	e14163
Number of pages	14
Journal	Pediatric Allergy and Immunology
Volume	35
Issue number	6
Early online date	2 Jun 2024
DOIs	https://doi.org/10.1111/pai.14163
Publication status	Published - Jun 2024

Bibliographical note

Copyright © 2024 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is the peer reviewed version of the following article: 'Meyer, R, Vandenplas, Y, Lozinsky, AC, Vieira, MC, Berni Canani, R, du Toit, G, Dupont, C, Giovannini, M, Uysal, P, Cavkaytar, O, Knibb, R, Fleischer, DM, Nowak-Wegrzyn, A & Venter, C (2024), 'Diagnosis and management of food allergy-induced constipation in young children-An EAACI position paper', Pediatric Allergy and Immunology, vol. 35, no. 6, e14163,' which has been published in final form at [https://doi.org/10.1111/pai.14163]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

Keywords

constipation
cow's milk allergy
food allergy induced constipation
food protein induced constipation
non-IgE-mediated allergy

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10.1111/pai.14163

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Meyer, R., Vandenplas, Y., Lozinsky, A. C., Vieira, M. C., Berni Canani, R., du Toit, G., Dupont, C., Giovannini, M., Uysal, P., Cavkaytar, O., Knibb, R., Fleischer, D. M., Nowak-Wegrzyn, A., & Venter, C. (2024). Diagnosis and management of food allergy-induced constipation in young children-An EAACI position paper. Pediatric Allergy and Immunology, 35(6), Article e14163. https://doi.org/10.1111/pai.14163

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title = "Diagnosis and management of food allergy-induced constipation in young children-An EAACI position paper",

abstract = "The 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.",

keywords = "constipation, cow's milk allergy, food allergy induced constipation, food protein induced constipation, non-IgE-mediated allergy",

author = "Rosan Meyer and Yvan Vandenplas and Lozinsky, {Adriana Chebar} and Vieira, {Mario C.} and {Berni Canani}, Roberto and {du Toit}, George and Christophe Dupont and Mattia Giovannini and Pinar Uysal and Ozlem Cavkaytar and Rebecca Knibb and Fleischer, {David M.} and Anna Nowak-Wegrzyn and Carina Venter",

note = "Copyright {\textcopyright} 2024 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is the peer reviewed version of the following article: 'Meyer, R, Vandenplas, Y, Lozinsky, AC, Vieira, MC, Berni Canani, R, du Toit, G, Dupont, C, Giovannini, M, Uysal, P, Cavkaytar, O, Knibb, R, Fleischer, DM, Nowak-Wegrzyn, A & Venter, C (2024), 'Diagnosis and management of food allergy-induced constipation in young children-An EAACI position paper', Pediatric Allergy and Immunology, vol. 35, no. 6, e14163,' which has been published in final form at [https://doi.org/10.1111/pai.14163]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley{\textquoteright}s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. ",

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Meyer, R, Vandenplas, Y, Lozinsky, AC, Vieira, MC, Berni Canani, R, du Toit, G, Dupont, C, Giovannini, M, Uysal, P, Cavkaytar, O, Knibb, R, Fleischer, DM, Nowak-Wegrzyn, A & Venter, C 2024, 'Diagnosis and management of food allergy-induced constipation in young children-An EAACI position paper', Pediatric Allergy and Immunology, vol. 35, no. 6, e14163. https://doi.org/10.1111/pai.14163

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T1 - Diagnosis and management of food allergy-induced constipation in young children-An EAACI position paper

AU - Meyer, Rosan

AU - Vandenplas, Yvan

AU - Lozinsky, Adriana Chebar

AU - Vieira, Mario C.

AU - Berni Canani, Roberto

AU - du Toit, George

AU - Dupont, Christophe

AU - Giovannini, Mattia

AU - Uysal, Pinar

AU - Cavkaytar, Ozlem

AU - Knibb, Rebecca

AU - Fleischer, David M.

AU - Nowak-Wegrzyn, Anna

AU - Venter, Carina

N1 - Copyright © 2024 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is the peer reviewed version of the following article: 'Meyer, R, Vandenplas, Y, Lozinsky, AC, Vieira, MC, Berni Canani, R, du Toit, G, Dupont, C, Giovannini, M, Uysal, P, Cavkaytar, O, Knibb, R, Fleischer, DM, Nowak-Wegrzyn, A & Venter, C (2024), 'Diagnosis and management of food allergy-induced constipation in young children-An EAACI position paper', Pediatric Allergy and Immunology, vol. 35, no. 6, e14163,' which has been published in final form at [https://doi.org/10.1111/pai.14163]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

PY - 2024/6

Y1 - 2024/6

N2 - The 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.

AB - The 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.

KW - constipation

KW - cow's milk allergy

KW - food allergy induced constipation

KW - food protein induced constipation

KW - non-IgE-mediated allergy

UR - https://onlinelibrary.wiley.com/doi/10.1111/pai.14163

UR - http://www.scopus.com/inward/record.url?scp=85194999673&partnerID=8YFLogxK

U2 - 10.1111/pai.14163

DO - 10.1111/pai.14163

M3 - Review article

C2 - 38825829

SN - 0905-6157

VL - 35

JO - Pediatric Allergy and Immunology

JF - Pediatric Allergy and Immunology

IS - 6

M1 - e14163

ER -

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

Abstract

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Keywords

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