Gastro-oesophageal Reflux and Cow’s Milk Allergy
Gastro-esophageal reflux disease (GERD) and cow’s milk allergy protein (CMPA) and are both common disorders in childhood, mainly infancy, and several studies have hypothesised a causal relationship between them, suggesting that at least in a subgroup of infants GERD is attributable to CMA. In children with CMPA, a neuroimmune interactions provoked by cow’s milk challenge might induce gastric motor abnormalities and in turn increase the number of reflux episodes. Studies assessing the relationship between the two conditions have shown an association ranging between 16 and 55%, which is far beyond from that expected from pure coexistence. Therefore, a possible concomitant CMPA, mainly in those infants and children with GERD unresponsive to medical treatment data, should be highly considered. Current ESPGHAN-NASPGHAN guidelines already suggest a short trial cow’s milk free diet in those infants with chronic regurgitation unresponsive to medical therapy, vomiting and failure to thrive.
KeywordsGastroesophageal reflux Cow’s milk protein allergy pHmetry pH-impedance
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