Very early onset perinatal constipation:Can it be cow’s milk protein allergy?  

作　　者：Rajalakshmy Arakoni Hebat Kamal Sam Xianjun Cheng 

机构地区：[1]Department of Pediatrics,University of Florida Shands Children's Hospital,Gainesville,FL 32608,United States [2]Department of Pediatric Gastroenterology,Hepatology,and Nutrition,University of Florida Shands Children's Hospital,Gainesville,FL 32608,United States

出　　处：《World Journal of Gastroenterology》2023年第33期4920-4926,共7页世界胃肠病学杂志（英文版）

摘　　要：Delayed passage of meconium or constipation during the perinatal period is traditionally regarded as a signal to initiate further work up to evaluate for serious diagnoses such as Hirschsprung’s disease(HD),meconium ileus due to Cystic Fibrosis,etc.The diagnosis of HD particularly warrants invasive testing to confirm the diagnosis,such as anorectal manometry or rectal suction biopsy.What if there was another etiology of perinatal constipation,that is far lesser known?Cow’s milk protein allergy(CMPA)is often diagnosed in infants within the first few weeks of life,however,there are studies that show that the CMPA allergen can be passed from mother to an infant in-utero,therefore allowing symptoms to show as early as day one of life.The presentation is more atypical,with perinatal constipation rather than with bloody stools,diarrhea,and vomiting.The diagnosis and management would be avoidance of cow's milk protein within the diet,with results and symptom improvement in patients immediately.Therefore,we discuss whether an alternative pathway to address perinatal constipation should be further discussed and implemented to potentially avoid invasive techniques in patients.This entails first ruling out CMPA with safe,noninvasive techniques with diet modification,and if unsuccessful,then moving forward with further diagnostic modalities.

关 键 词：Delayed passage of meconium Perinatal constipation Cow's milk protein allergy IN-UTERO Alternate pathway Hirschsprung’s disease 

分 类 号：R574[医药卫生—消化系统]