IMPORTANT The information provided is of a general nature and should not be used as a substitute for professional advice. If you think you may suffer from an allergic or other disease that requires attention, you should discuss it with your family doctor. The content of the information articles and all illustrations on this website remains the intellectual property of Dr Raymond Mullins and cannot be reproduced without written permission.

Constipation in young children is not rare. Treatment options include adding fibre to the diet, stool softeners (eg. non absorbable sugars like lactulose or Duphalac) so that bowel motion do not come out like concrete (thus causing pain and a desire to “hold on”) or gut stimulants that make the bowel work harder. But is constipation a form of food allergy?

Well, a number of small studies (some randomised) have trialled a dairy free diet for a month and report success rates of between 28 and 78%. A possible mechanism has been diet-provoked inflammation in the lower bowel. If constipation is a major problem, some paediatricians will recommend a trial for a month to see if it helps, and then diet liberalisation after another 12 months if clearly helpful. But allergy testing is of no use in this condition. Long term dietary restrictions should not be undertaken without medical and dietetic supervision due to risks of malnutrition, especially when restricting important sources of nutrients in early life like dairy products.

References

1: Treatments for Constipation: A Review of Systematic Reviews [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014 Nov 17.

2: 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: 10.1159/000362365.

3: 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 Mar;21(2 Pt 2):e407-12. doi: 10.1111/j.1399-3038.2009.00898.x.

4: Crowley ET, Williams LT, Roberts TK, Dunstan RH, Jones PD. Does milk cause constipation? A crossover dietary trial. Nutrients. 2013 Jan 22;5(1):253-66. doi: 10.3390/nu5010253.

5: Irastorza I, Ibañez 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 Aug;51(2):171-6. doi: 10.1097/MPG.0b013e3181cd2653.

6: 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 Dec;22(4):468-74.

7: Biggs WS, Dery WH. Evaluation and treatment of constipation in infants and children. Am Fam Physician. 2006 Feb 1;73(3):469-77.

Last reviewed 12 July 2020