Could Ig E Mediated Cow's Milk Protein Allergy Be a Risk Factor in the Development of Functional Gastrointestinal Disease?

Objectives Numerous factors have been implicated in the development of functional gastrointestinal disorders (FGID). In this study, we aimed to investigate whether a diagnosis of cow’s milk protein allergy (CMPA) in infancy is a risk factor for the development of FGID in the long term and whether there is a difference between patients with IgE-mediated and non-IgE-mediated CMPA with regard to the development of FGID. Methods The study included 250 patients aged 4–18 years who had been diagnosed with CMPA in infancy. The control group consisted of 250 children of a similar age without CMPA. A questionnaire including Rome IV criteria was prepared and administered to the parents of 500 children. Results FGID were observed in 70 (28%) patients with CMPA and in 76 (30.4%) patients without CMPA ( p  = 0.623). functional abdominal pain-not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS), and non-retentive fecal incontinence (NRFI) were significantly more common in patients without CMPA ( p  = 0.009, p  = 0.016, p  = 0.034, respectively). FGID were observed in 36 (33.6%) patients with IgE-mediated CMPA as opposed to 34 (23.8%) patients with non-IgE-mediated CMPA ( p  = 0.115). functional dyspepsia (FD), FAP-NOS, and IBS were significantly more common in patients with IgE-mediated CMPA ( p  ≤ 0.001, p  = 0.001, p  = 0.002, respectively). Conclusion Although the frequency of FGID development did not increase in the long term in our CMPA patients, FD, FAP-NOS, and IBS were significantly more common in these patients, particularly in those with IgE-mediated CMPA. This suggests that subclinical CMPA may persist in patients with IgE-mediated CMPA.