{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:15:03Z","timestamp":1790709303501,"version":"4.1.0"},"reference-count":190,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Constipation is a very common disorder, mostly functional in nature, that may persist for years in up to 35\u201352% of children. Food allergy prevalence, severity and persistence are increasing over time, and cows\u2019 milk protein is the commonest food allergen recognised to affect gastrointestinal motility in children. There is mounting evidence of the role of cows\u2019 milk (CM) allergy (CMA) in children with constipation. With this narrative review, we aim to provide clinicians with an updated and critical overview of food allergy-associated constipation. We searched Embase, Medline and the Cochrane Library, using keywords related to the topic. Only reviews and studies including children aged 0\u201317 years that were published in English were considered. Constipation has been reported in 4.6% of infants with CMA; the prevalence of food allergy underlying chronic constipation in children resistant to conventional treatment and presenting to tertiary clinics ranges between 28% and 78%. The identification of predisposing risk factors and of a specific phenotype of food allergy-induced constipation remains elusive. No allergic tests, radiological or motility investigations achieve sufficient sensitivity and specificity to screen children for CMA-related constipation. A 4-week cows\u2019 milk protein (CMP) elimination diet may be considered for children with chronic constipation resistant to conventional treatment and who lack alarm sign\/symptoms of organic diseases. In subjects with ameliorated symptoms on CMP elimination, the diagnosis of CMA should be confirmed by a food challenge to avoid an unnecessary protracted diet.<\/jats:p>","DOI":"10.3390\/nu14061317","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T21:48:42Z","timestamp":1647899322000},"page":"1317","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Cows\u2019 Milk Allergy-Associated Constipation: When to Look for It? A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Frances","family":"Connor","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children\u2019s Hospital, Brisbane 4101, Australia"},{"name":"Mayne Academy of Pediatrics, Faculty of Medicine, University of Queensland, Brisbane 4101, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Salvatore","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ospedale \u201cF. Del Ponte\u201d, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2750-5810","authenticated-orcid":false,"given":"Enza","family":"D\u2019Auria","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital, University of Milan, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0590-6664","authenticated-orcid":false,"given":"Maria Elisabetta","family":"Baldassarre","sequence":"additional","affiliation":[{"name":"Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, \u201cAldo Moro\u201d University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Acunzo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital, University of Milan, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0635-6051","authenticated-orcid":false,"given":"Gaia","family":"Di Bella","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ospedale \u201cF. Del Ponte\u201d, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Farella","sequence":"additional","affiliation":[{"name":"Department of Biomedical Science and Human Oncology, Clinica Medica \u201cA. Murri\u201d, \u201cAldo Moro\u201d University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Sestito","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Pediatric Unit, University \u201cMagna Graecia\u201d of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2043-5530","authenticated-orcid":false,"given":"Licia","family":"Pensabene","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Pediatric Unit, University \u201cMagna Graecia\u201d of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jpeds.2017.12.012","article-title":"Prevalence of Pediatric Functional Gastrointestinal Disorders Utilizing the Rome IV Criteria","volume":"195","author":"Robin","year":"2018","journal-title":"J. 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