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.
Review article: chronic constipation and food hypersensitivity –an intriguing relationship. A. CARROCCIO* & G. IACONO. 2006. Alimentary Pharmacology and Therapeutics 2006; 24: 1295-1304.
Discusses the research available up until 2006 regarding dairy causing constipation in both children and adults.
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.
Chronic Constipation and Food Hypersensitivity – An Intriguing Relationship. A. Carroccio, G. Iacono. Aliment Pharmacol Ther. 2006;24(9):1295-1304.
Great review article on the topic of food intolerance causing chronic constipation. Helpful.
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 Pediatrics. 2009, 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 children. Nadeem 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.
Milk fats clue to inflammatory bowel disease: http://www.newscientist.com/article/dn21920-milk-fats-clue-to-inflammatory-bowel-disease.html
This is not about constipation, per se, but it does remind me that our intrinsic probacterial flora plays a huge role in manifestation of our disease–whichever it may be–and diet affects the probiotic flora. In this case, milk fat. Not protein. Interesting to follow along.
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.