Part 2 - The role of cow's milk protein intolerance in chronic diarrhoea in a developing community

Abstract

Publisher Summary This chapter discusses the role of food intolerance. The place of cow's milk protein intolerance and cow's milk protein sensitive enteropathy in post-enteritis chronic diarrhea and failure to thrive in infants in developed countries is well established. A high incidence of delayed recovery in infants following admission to the Gastroenteritis Unit with acute diarrhea is shown. The incidence was particularly high in infants aged less than 6 months, in infants weighing less than the 3rd centile for age and in infants of Indian or Bangladeshi ethnic origin. A proportion of these infants had demonstrable lactose intolerance while others did not. In a study reviewed in the chapter, all 37 infants showed mucosal healing after 2–4 weeks on a cow's milk exclusion diet supplemented by Pregestimil. This mucosal healing occurred despite the absence of any environmental change other than the cow's milk exclusion. It is found that when the mucosa had improved at this stage none were lactose intolerant. Twenty infants showed mucosal relapse on cow's milk challenge and were considered to have cow's milk protein sensitive enteropathy.