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PubMed1979

[Milk intolerance in Colombian children, its prevalence and relation to lactose malabsorption].

A total of 121 children from an orphange were studied. Their ages ranged from 2 to 10 years and represented different ethnic backgrounds. The prevalence of malnutrition was 45% and their gastrointestinal symptomatology in response to graded amounts of milk intake was evaluated. None of the children complained when milk intakes were of 200 cc; 10% complained of gastrointestinal discomfort and/or diarrhea when 300 cc of milk (equivalent to 12 g of lactose) were administered, and 54% presented lactose malabsorption unrelated to ethnic background, sex or malnutrition. It is concluded that the prevalence of milk intolerance is minimal when milk is given in the usual amounts.

Age Factors↗
PubMed1976

Enterocolitis in low-birth-weight infants associated with milk and soy protein intolerance.

Two low-birth-weight infants developed a syndrome of vomitting, distension, septic appearance, and bloody diarrhea. Both infants developed symptoms after ingestion of cow milk-based formula initially, and, later, soy-based formulas. These symptoms resolved with intravenous fluids and alimentation. Vomiting, diarrhea, melena, and polymorphonuclear leukocytosis recurred with reintroduction of either milk- or soy-based formulas. This sensitivity persisted throughout the neonatal period and was still present at seven to eight months of age. It appears from these data that intolerance to whole protein formulas can cause a syndrome similar clinically to neonatal necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗
PubMed1990

[51Cr]EDTA intestinal permeability in children with cow's milk intolerance.

Making use of [51Cr]EDTA as a permeability marker, we measured intestinal permeability in a group of 20 children with proven cow's milk intolerance (CMI), a group of 17 children with similar complaints where CMI was excluded (sick controls), and a group of 12 control children. [51Cr]EDTA test results (mean +/- SD) were 6.85 +/- 3.64%, 3.42 +/- 0.94%, and 2.61 +/- 0.67% in the group with CMI, the sick control, and the control group, respectively. When compared to both control groups, patients with cow's milk intolerance (CMI) showed a significantly increased small bowel permeability. We conclude that the [51Cr]EDTA test can be helpful for the diagnosis of cow's milk intolerance.

Animals↗
PubMed1977

Soy protein intolerance: four patients with concomitant cow's milk intolerance.

An infrequently encountered and poorly understood infantile disorder is gastrointestinal soy protein intolerance. Four patients who had intractable diarrhea of infancy and who failed to thrive were tested by oral challenge with soy protein isolate and were found to have soy protein intolerance. All four exhibited concomitant sensitivity to cow's milk protein. The response to challenge with soy protein included diarrhea, vomiting, hypotension, lethargy, and fever. These symptoms were immediate, of short duration, and occurred with each subsequent challenge dose. No patient exhibited cutaneous, pulmonary, or hematologic evidence of allergy although it was prominent in their families. A diet devoid of intact soy and cow's milk protein allowed symptomatic recovery and rapid weight gain. Oral disodium cromoglycate therapy was ineffective in one trial. Soy protein intolerance should be suspected in infants with diarrhea resistant to therapy with soy based formulas.

Body Weight↗
PubMed1988

[Systemic humoral immune response to food antigens following oral immunization or immunization via the respiratory tract].

Differences and similarities of the systemic humoral immune response to cow's milk proteins were investigated after exposure of the gut or of the airways to antigen, both in children and in rabbits. Circulating antibodies were determined by radioimmunoassay (children and rabbits) and by enzyme-linked immunosorbent-assay in a small number of children. An age-dependent reference range was established, reflecting the rapid change of active antibody formation after oral immunization against bovine serum albumin in healthy, non-breastfed children up to the age of 24 months (n = 181). In contrast 16 children with recurrent aspiration due to anatomical disturbances or swallowing difficulties, all had antibody-titers well above this reference range. 7 of 9 children with cow's milk protein intolerance and with failure to thrive (oral immunization) also showed high concentrations of milk antibodies in the circulation. In adult rabbits immunized by oral or inhalational route, the vigorous immune response seen in recurrent aspiration could be mimicked. As investigated by enzyme-linked immunosorbent assay, higher titers of antibodies to bovine serum albumin, alpha-lactalbumin, beta-lactoglobulin, alpha-casein and bovine gammaglobulin could be shown in all isotypes tested (specific anti-IgG, -IgA, and -IgE) both in recurrent aspiration (n = 11) and cow's milk protein intolerance (n = 4) as compared to normal age-matched children (n = 14).

Animals↗
PubMed1981

[Cow's milk protein intolerance: clinical and pathogenic aspects (author's transl)].

Cow's milk protein intolerance is a transient food intolerance of early infancy. Ingestion of cow's milk protein causes an enteropathy of variable degree. Clinical manifestations are primarily gastrointestinal, although dermal and respiratory symptoms add to the clinical syndrome. Three types are found: an acute anaphylactic reaction, a chronic mild form, and a chronic severe form which is of utmost practical importance in severe protracted diarrhoea of infancy. A graduated diagnostic procedure is proposed, taking into account clinical and morphological reactions to cow's milk proteins. Pathogenesis is immunologically mediated. A concept of transient food protein intolerance is developed which has to be separated from the permanent intolerance of gluten in coeliac disease. Prognosis of cow's milk protein intolerance is excellent after elimination of the offending agent. Breast feeding seems to be effective in prevention of the disease.

Anaphylaxis↗
PubMed2006

Food allergies.

Food incompatibilities affect approximately 20% of the general population in Western countries. In about one quarter of the affected children and one tenth of affected adults, the incompatibility is based on an allergy, that is, on an immunologically generated incompatibility reaction. Gastrointestinal symptoms occur in a third of these cases. Food allergies are caused by IgE-dependent orIgE-independent immunologic reactions, which lead to an inflammatory reaction, in which mast cells, eosinophilic granulocytes, and other cells are involved. Both genetic and environmental causes are under consideration. New findings concerning the interaction between the innate immune system and intestinal microflora have generated innovative therapeutic concepts, including the use of probiotics to prevent food allergies. The development of recombinant allergens and varieties of allergens will improve diagnostic possibilities and bring new therapeutic options, such as hyposensitization and induction of immunologic tolerance. Food intolerances (non-immunologic food incompatibilities often caused by specific enzyme deficiencies) must be diagnostically differentiated from food allergies.

Adult↗
PubMed1982

Food intolerance: a major factor in the pathogenesis of irritable bowel syndrome.

Specific foods were found to provoke symptoms of irritable bowel syndrome (IBS) in 14 of 21 patients. In 6 patients who were challenged double blind the food intolerance was confirmed. No difference was detected in changes in plasma glucose, histamine, immune complexes, haematocrit, eosinophil count, or breath hydrogen excretion produced after challenge or control foods. Rectal prostaglandin E2 (PGE2), however, increased significantly, and in a further 5 patients rectal PGE2 correlated with wet faecal weight. Food intolerance associated with prostaglandin production is an important factor in the pathogenesis of IBS.

Citrus↗
PubMed1979

Difference in calcium metabolism following Billroth-I and Billroth-II procedures for gastric and duodenal ulcers.

There have been 7 patients with postoperative osteomalacia in our series of 500 patients who had a gastrectomy for gastric or duodenal ulcers. All seven of these patients had a Billroth-II type gastrojejunostomy or esophagojejunostomy which caused food to bypass the duodenum and the upper part of the jejunum, and six of these patients showed milk intolerance and had diarrhea on food other than cow's milk. From this finding, it may be surmised that patients are predisposed to osteopenia after gastrectomy due to disorder in the process of calcium absorption and they develop osteomalacia when treated with the Billroth-II procedure, showing milk intolerance and diarrhea on food other than cow's milk.

Adult↗
PubMed1978

Respiratory hydrogen excretion as a parameter for lactose malabsorption in children.

Respiratory hydrogen excretion was measured during tolerance tests with lactose, glucose plus galactose, and skim milk in 52 children, 4 to 15 years of age. Ten children appeared to be lactose-malabsorbers, as reflected by increased respiratory hydrogen excretion after administration of 2 g lactose per kilogram, maximum 50 g. Skim milk, equivalent to 0.5 g lactose per kilogram was administered to all lactose-malabsorbers. Eight children were tolerant and two children were "intolerant" for this physiological amount of lactose when administered as skim milk. Disaccharidase activities of jejunal biopsies were determined in all 10 children with lactose malabsorption. Lactase activity was deficient in nine children and normal in one child. The increase of blood glucose during the lactose tolerance test did reflect lactose malabsorption less accurately than the respiratory hydrogen excretion.

Adolescent↗
PubMed1989

Clinical manifestations of the thrombocytopenia and absent radii (TAR) syndrome.

Six patients with the classical features of the TAR syndrome were diagnosed at birth. In one case an older sibling was also affected. The characteristic features of foreshortened forearms and radially deviated hands were noted in all cases at presentation and confirmed radiologically. With one exception skeletal abnormalities of the lower limbs were also present. Varying degrees of thrombocytopenia were present at birth with three of the five patients having platelet counts below 50 x 10(9)/L. Bone marrow examination was performed in two patients and revealed an absence of normal megakaryocytes. Two patients with severe thrombocytopenia had bleeding complications during infancy requiring transfusion support. Severe gastroenteritis occurred in two patients, in one of whom it was attributed to cow's milk intolerance. In all patients the platelet count has risen progressively since birth. Orthopedic surgical procedures have been performed without hemorrhagic complications.

Diseases in Twins↗
PubMed1978

[Galactosemia and cow's milk intolerance (author's transl)].

The clinical, biochemical and anatomical studies of one case of galactosemia with cow's milk intolerance in a one month old infant are reported. Diagnosis was ascertained measuring the enzyme (Gal-1-P-Uridyl-transferase) deficiency with the methods of Anderson, Kalckar and Isselbacher. Overload and enzymatic studies were also carried out in relatives. The interest of this association of galactosemia with cow's milk intolerance, and its clinical and therapeutic implications are pointed out in the discussion.

Animals↗
PubMed1977

Malabsorption associated with diarrhea and intestinal infections.

An episode of diarrhea causes weight loss and a temporary cessation of growth in infants and children. Diarrhea is accompained by malabsorption of sugars, nitrogen, fats, and micronutrients. The mechanisms by which acute diarrheal disease produce malabsorption have not been studied carefully. The nutritional costs of malabsorption may pose a major threat if diarrhea becomes chronic or recurrent. The hydrogen breath test for carbohydrate malabsorption does not require intubation or blood drawing and can be used in children to help clarify the importance of carbohydrate intolerance in the duration and perpetuation of acute diarrhea and intestinal bacterial overgrowth.

Bacterial Infections↗
PubMed1983

Response of patients with irritable bowel syndrome and lactase deficiency using unfermented acidophilus milk.

Acidophilus milk has been reported to help patients with irritable bowel syndrome by correcting the "imbalance of flora" and to be tolerated better by lactase-deficient subjects by providing bacterial lactase in the small intestine. In a double-blind randomized study, 61 lactase-sufficient patients with irritable bowel syndrome each ingested 240 ml of milk three times a day for 2 wk and the same amount of acidophilus milk for an additional 2 wk. The degree of symptoms during the two milk-drinking periods was the same as during the control periods. Also, 18 lactase-deficient patients ingested unaltered milk for 1 wk and acidophilus milk for 1 additional wk. There was no difference in the degree of tolerance to the two varieties of milk. In summary, patients with irritable bowel syndrome were not helped by the ingestion of acidophilus milk, and lactase-deficient patients were as intolerant to acidophilus milk as to unaltered milk.

Adolescent↗