Cow’s Milk and Refractory Constipation

Dripped homemade yogurt

Dripped homemade yogurt

Here below, I’ve listed some medical articles that I have read in the last six months regarding chronic constipation and dairy’s potential role in its causation.  No physician, in a professional relationship or friend relationship, ever mentioned to me or my husband that dairy could be causing my daughter’s chronic constipation that required daily Miralax for years.  I just don’t think they knew that constipation could be a nearly sole symptom of milk-intolerance.  I didn’t.  I do now, and so do they  (they’ve been texted, e-mailed, called, and “Christmas card updated”).

As dairy elimination did not take care of my issue with the same problem, I was relieved to find some journal articles on multiple food intolerances leading to chronic constipation.  I am doing this thing called the GAPS diet for my gut, I don’t know if it is working as a “whole regimen” or if going through the diet has allowed me to identify problematic foods.  Regardless, things are better for myself and my daughter, and I am glad I found these articles helping me to look beyond dairy as constipation triggers.  Laxatives were not working for me so well, and I was getting worried.

As I will and must say, it is ever important to make sure that there’s no serious disorder that needs to be evaluated–like cancer, inflammatory bowel disease, or another bad illness.  I’ve seen my doctors, and so must you make sure that nothing is being missed in your own body.  Also, I would like to point out that, although many of these articles are regarding children, my constipation started in early childhood–so I translated the studies to myself and adult studies seem to support this.

  • Chronic constipation and food intolerance: a model of proctitis causing constipation.Carroccio A, Scalici C, Maresi E, Di Prima L, Cavataio F, Noto D, Porcasi R, Averna MR, Iacono G.  Scand J Gastroenterol 2005 Jan; 40(1):33-42.
    A pediatric study finding cow’s milk intolerance manifesting as constipation in 24/52 patients.  Actual pathologic changes were found in the rectal mucosal biopsies of these affected patients, as well as decreased rectal mucus-gel layer.
    (Proctitis is basically the inflammation of the anus and lower rectum, resulting in clinical symptoms of cramping, feeling like you still have to have a bowel movement even after you’ve had one, painful defecation, anal irritation/itching, and pus or blood in bowel movement.  It can be caused by many things, but in this study, they found that dairy intolerant kids had it.)
  • Multiple food hypersensitivity as a cause of refractory chronic constipation in adults.  ANTONIO CARROCCIO, LIDIA DI PRIMA, GIUSEPPE IACONO, ADA M. FLORENA, FRANCESCO D’ARPA, CARMELO SCIUME` , ANGELO B. CEFALU`, DAVIDE NOTO & MAURIZIO R. AVERNA.  Scandinavian Journal of Gastroenterology, 2006; 41: 498/504.   A very small sample of four women was found to have severe, refractory constipation alleviated by initiation of an oligo-antigenic diet (hypoallergenic diet–put simply, the women were put on a limited diet of foods that most people are not allergic to).  Elimination diet eventually allowed each patient to pinpoint multiple food intolerances causing their constipation.  Researchers also found pathologic changes in the rectum, duodenum, and esophagus of the patients as well.

  • Intolerance of Cow’s Milk and Chronic Constipation in Children  Giuseppe Iacono, M.D., Francesca Cavataio, M.D., Giuseppe Montalto, M.D., Ada Florena, M.D., Mario Tumminello, M.D., Maurizio Soresi, M.D., Alberto Notarbartolo, M.D., and Antonio Carroccio, M.D.  N Engl J Med 1998;  339:1100-1104October 15, 1998DOI:  10.1056/NEJM199810153391602.  One of the first larger studies to support milk causing childhood chronic constipation.  Also read the interesting editorials that both try to refute and support the findings.  I believe the first criticism may be concerned about the implications of removing a nutrition-packed food source from children’s diets, especially very young children.

  • Functional constipation in children: does maternal personality matter?  Alireza Farnam, Mandana Rafeey, Sara Farhang* and Saeedeh KhodjastejafariItalian.  Journal of Pediatrics2009, 35:25 doi:10.1186/1824-7288-35    As  my daughter quickly responded to dairy removal, I found this research article quite comical  (but I’m secretly relieved that dairy elimination and low nut intake keeps her regular!  Laugh!).

  • Constipation in childrenNadeem A Afzal1*, Mark P Tighe2 and Mike A Thomson3  Italian Journal of Pediatrics 2011, 37:28 doi:10.1186/1824-7288-37-28.
    A review article in general about childhood constipation.  A brief blurb in there about cow-milk deserving a trial if there’s a family history of cow-milk intolerance, etc.  However, in our family, prior to May, we were completely unaware of “milk-intolerance” presence in our family, as I just did not know that sinusitis, chronic cough, and constipation could be related to dairy intolerance.

  • World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines.  Alessandro Fiocchi, (Chair), Jan Brozek, Holger Schu¨nemann, (Chair), Sami L. Bahna, Andrea von Berg, Kirsten Beyer, Martin Bozzola, Julia Bradsher, Enrico Compalati, Motohiro Ebisawa, Maria Antonieta Guzman, Haiqi Li, Ralf G. Heine, Paul Keith, Gideon Lack, Massimo Landi, Alberto Martelli, Fabienne Rancé, Hugh Sampson, Airton Stein, Luigi Terracciano, and Stefan Vieths.  WAO Journal.  2010.  57-161.  A huge review article.  But buried in there are segments on constipation and dairy.  Also other good information.

If you’re reading this to help yourself or your child, best wishes to you on your endeavors, and I hope you find clues to better GI health soon!
Update:  I have come back through to edit this post a little.  Our constipation has improved significantly with the removal of all dairy products.  We even tried goat’s milk, but we failed the trial.  My daughter occasionally gets ice cream or a cake with some dairy in it at a birthday party or on vacation, and we have noticed that although she may skip a couple of days, her GI tract gets moving again without any Miralax.  Definitely an improvement!
Other constipation posts:

7 thoughts on “Cow’s Milk and Refractory Constipation

  1. Pingback: Dairy Causes Some Kids to Have Constipation | The HSD

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  4. Debbie

    I wonder if the studies were done using homogenized and pasteurized conventional milk or raw whole milk from grass fed, pasture raised cows? I wonder what the differences might be? Are you familiar with Sally Fallon and the Weston Price Foundation?

    Reply
    1. thehomeschoolingdoctor Post author

      Hi, Debbie:

      I don’t remember, but I’d bet a chunk of money that it was not grass-fed, pasture-raised.

      I am familiar with Sally Fallon and the Weston Price Foundation. Most people who do the GAPS diet are because it is suggested to try to transition to eating in line with traditional methods, as Sally Fallon and the WAPF recommend.

      I am not a fan of commercial milk or commercial milk products. I worry about these.

      I think that some people will react to dairy no matter what it’s form or source. Still others will be able to tolerate some form of dairy: butter or 24 hour fermented yogurt or goat cheese, etc. Others may work on their leaky guts and then be able to tolerate one of the forms. Or maybe they’ll never be able to tolerate any form. Dairy products have so many pesky proteins (and sugars–who knows—maybe even fats—I read about that once). Personally, I’m hoping to fix my leaky gut and be able to eat 24 hour fermented yogurt and butter. Those are my goals. 🙂 (I can’t bring myself to drink raw milk or advocate it. Interestingly, I was told my great-grandmother boiled her milk before giving it to her family.)

      I hope you have a great day!

      Terri

      Reply

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