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Cited by 364

The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.

Intolerance of Cow's Milk and Chronic Constipation in Children

Iacono, Giuseppe, Cavataio, Francesca, Montalto, Giuseppe, Florena, Ada, Tumminello, Mario, Soresi, Maurizio, Notarbartolo, Alberto, Carroccio, Antonio·1998·New England Journal of Medicine
DOI 10.1056/nejm199810153391602
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Abstract

BACKGROUND: Chronic diarrhea is the most common gastrointestinal symptom of intolerance of cow's milk among children. On the basis of a prior open study, we hypothesized that intolerance of cow's milk can also cause severe perianal lesions with pain on defecation and consequent constipation in young children. METHODS: We performed a double-blind, crossover study comparing cow's milk with soy milk in 65 children (age range, 11 to 72 months) with chronic constipation (defined as having one bowel movement every 3 to 15 days). All had been referred to a pediatric gastroenterology clinic and had previously been treated with laxatives without success; 49 had anal fissures and perianal erythema or edema. After 15 days of observation, the patients received cow's milk or soy milk for two weeks. After a one-week washout period, the feedings were reversed. A response was defined as eight or more bowel movements during a treatment period. RESULTS: Forty-four of the 65 children (68 percent) had a response while receiving soy milk. Anal fissures and pain with defecation resolved. None of the children who received cow's milk had a response. In all 44 children with a response, the response was confirmed with a double-blind challenge with cow's milk. Children with a response had a higher frequency of coexistent rhinitis, dermatitis, or bronchospasm than those with no response (11 of 44 children vs. 1 of 21, P=0.05); they were also more likely to have anal fissures and erythema or edema at base line (40 of 44 vs. 9 of 21, P<0.001), evidence of inflammation of the rectal mucosa on biopsy (26 of 44 vs. 5 of 21, P=0.008), and signs of hypersensitivity, such as specific IgE antibodies to cow's-milk antigens (31 of 44 vs. 4 of 21, P<0.001). CONCLUSIONS: In young children, chronic constipation can be a manifestation of intolerance of cow's milk.

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Show all 10 references

Research works printed but not linked: 11

  1. 10.1016/S0022-3476(86)80834-4 · doi:10.1016/s0022-3476(86)80834-4
  2. 10.1136/adc.51.12.918 · doi:10.1136/adc.51.12.918
  3. 10.1111/j.1651-2227.1973.tb08120.x · doi:10.1111/j.1651-2227.1973.tb08120.x
  4. Pinkerton P, 1957, Arch Dis Child, 24, 371
  5. 10.1016/S0022-3476(85)80660-0 · doi:10.1016/s0022-3476(85)80660-0
  6. 10.1097/00005176-198506000-00013 · doi:10.1097/00005176-198506000-00013
  7. Younoszai MK, Tolaymat N. Chronic functional constipation in infants and children. In: Lebenthal E, ed. Textbook of gastroenterology and nutrition in infancy. 2nd ed. New York: Raven Press, 1989:1311-26.
  8. 10.1016/S0022-3476(95)70496-5 · doi:10.1016/s0022-3476(95)70496-5
  9. 10.1136/adc.64.9.1256 · doi:10.1136/adc.64.9.1256
  10. 10.1136/bmj.287.6405.1593 · doi:10.1136/bmj.287.6405.1593
  11. 10.1136/bmj.288.6412.236-a · doi:10.1136/bmj.288.6412.236-a

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Metadata

Authors
Iacono, G., Cavataio, F., Montalto, G., Florena, A., Tumminello, M., Soresi, M., Notarbartolo, A., & Carroccio, A.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1998-10-15
Volume
339
Issue
16
Pages
1100-1104
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199810153391602
OpenAlex
W2015962917
Cited by
364
References
10
FWCI
16.77
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Intolerance of Cow's Milk and Chronic Constipation in Children. https://app.cochat.ai/papers/10.1056/nejm199810153391602
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Iacono, G., Cavataio, F., Montalto, G., Florena, A., Tumminello, M., Soresi, M., Notarbartolo, A., & Carroccio, A. (1998). Intolerance of Cow's Milk and Chronic Constipation in Children. New England Journal of Medicine. https://doi.org/10.1056/nejm199810153391602

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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