Gut Problems
Allergic gut problems
These will manifest as problems with the movement of the gut, ie conditions such as allergic related gastro-oesophageal reflux, upper gut movement disorders and constipation. Cow’s milk protein (and soya as there is up to a 40% cross sensitivity between these two proteins in children in the gut) allergy can account for up to 40% in different series of infantile gastro-oesophageal reflux and childhood chronic constipation. There is good evidence that a trial of exclusion of cow’s milk protein and soya using special milks called hypoallergenic milks (Aptamil Pepti, Althera , Nutramigen, Pepti-Junior, Pregestimil) or elemental milks (Alfamino , Neocate, Neocate Advance, Neocate Junior, Puramino) can help substantially in determining whether children’s problems are due to this issue or not. The trials of these milks would normally be 2 weeks and if a baby is being breastfed at the same time sometimes it is advised to continue to express breast milk so that the provision of breast milk is still present if the hypoallergenic trial after 2 weeks does not week. Sometimes breast feeding will continue at the same time and the child’s mother is advised to exclude dairy and soya from her diet whilst a hypoallergenic milk is added if necessary
Older children may indeed have symptoms similar to irritable bowel syndrome due to allergies such as those with cow’s milk protein, soya or wheat and other food stuffs. This is often precipitated by a bad viral or other gut infection which then allows sensitisation of the gut to these proteins and then a child has often a movement of the gut which can take some time to resolve. The virus associated with glandular fever is particularly potent at disturbing the wiring controlling the movement of the gut. Allergies come under the umbrella term of intolerances and should not be confused with such disorders as enzyme deficiencies. It is particularly important not to confuse the allergy due to cow’s milk protein with lactose intolerance, which is the sugar in dairy produce and is in infancy very uncommon. Lactose intolerance due to the deficiency of the enzyme lactase can occur more commonly in people from Mediterranean regions and the Indian sub-continent and usually then comes on between the ages of 10 or 12 although it is known to occur earlier in life. This is not an allergy and very often confusion arises between cow’s milk protein, ie dairy allergy, causing gut problems and lactose intolerance, which is not an allergy but an enzyme deficiency. Intolerances to other food stuffs can also be present such as that with the refined sugar sucrose.
Acute allergic reactions such as asthma, hay fever and eczema are becoming increasingly common, probably due to the clean environment hypothesis where we are not exposed to as much dirt and therefore the body needs to respond to some things going in to it and this is probably the reason why there is an explosion in allergy. As part of this explosion gut related allergies are increasing also. Blood tests and skin prick tests and skin patch tests for non-IgE mediated allergy involving the gut are not helpful in determining which foods might be potential culprits. These tests are only useful for IgE mediated acute reactions such as asthma, eczema, hay fever and anaphylaxis. IgG tests for food allergies are not scientifically proven or valid at this time, despite the claims made by commercial companies from the internet.
For any straight forward nutritional issues please see an excellent text:
The Food Doctor for Babies and Children Vicki Edgson
Collin and Brown – ISBN: 1-84340-000-6
