Abstract
Background: Regurgitation and vomiting are common manifestations of cow's milk protein allergy (CMPA) in infants and are usually ascribed to gastroesophageal reflux (GER). Gastric anaphylaxis can induce antral dysmotility in the rat, and therefore the hypothesis for the current study was that cow's milk in sensitized infants may impair antral motility, thereby promoting GER and reflex vomiting. Methods: Seven vomiting infants with CMPA and nine with primary GER underwent a challenge with cow's milk formula. Electrogastrography (EGG) was used to measure the spectral frequency (bradygastria = 1.5-2.4 cycles per minute [cpm], normogastria = 2.5-3.9 cpm, tachygastria = 4.0-9.0 cpm) and the postprandial-to-fasting power ratio of gastric electrical activity, whereas gastric half-emptying time (T1/2) was measured by electrical impedance tomography (EIT). Results: In CMPA and GER, respectively, during fasting, the frequency distribution (mean ± SD) of the EGG was as follows: normogastria 47.9% ± 12.5% versus 52.2% ± 9.8%, bradygastria 24.1% ± 5.7% versus 22.8% ± 8.3%, and tachygastria 28.0% ± 8.5% versus 25.0% ± 8.3%. In contrast, after the cow's milk challenge, the difference between the two groups was statistically significant: normogastria 33.1% ± 8.8% versus 70.6% ± 8.6% (P <0.0001), bradygastria 38.0% ± 15.5% versus 15.7% ± 5.2% (P = 0.002), and tachygastria 28.9% ± 10.6% versus 13.4% ± 4.6% (P = 0.001. The postprandial/fasting power ratio (mean ± SD) was 3.2 ± 1.9 in CMPA and 8.1 ± 2.1 in GER (P <0.0001). Gastric T1/2 (mean ± SD) of the cow's milk meal was 89.0 ± 26.3 minutes versus 54.0 ± 12.6 minutes (P = 0.003). In infants with GER all EGG parameters and gastric T1/2 were similar to that in 10 healthy control infants. Conclusions: In sensitized infants, cow's milk induces severe gastric dysrhythmia and delayed gastric emptying, which in turn may exacerbate GER and induce reflex vomiting. Electrogastrography and EIT can be useful in the assessment of vomiting, GER, and CMPA in infants.
| Original language | English |
|---|---|
| Pages (from-to) | 59-64 |
| Number of pages | 6 |
| Journal | Journal of Pediatric Gastroenterology and Nutrition |
| Volume | 32 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2001 |
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Keywords
- Cow's milk protein allergy
- Electrical impedance tomography
- Electrogastrography
- Gastroesophageal reflux
- Vomiting
ASJC Scopus subject areas
- Gastroenterology
- Histology
- Medicine (miscellaneous)
- Food Science
- Pediatrics, Perinatology, and Child Health
Cite this
Vomiting and gastric motility in infants with cow's milk allergy. / Ravelli, Alberto M.; Tobanelli, Pamela; Volpi, Sonia; Ugazio, Alberto G.
In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 32, No. 1, 2001, p. 59-64.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Vomiting and gastric motility in infants with cow's milk allergy
AU - Ravelli, Alberto M.
AU - Tobanelli, Pamela
AU - Volpi, Sonia
AU - Ugazio, Alberto G.
PY - 2001
Y1 - 2001
N2 - Background: Regurgitation and vomiting are common manifestations of cow's milk protein allergy (CMPA) in infants and are usually ascribed to gastroesophageal reflux (GER). Gastric anaphylaxis can induce antral dysmotility in the rat, and therefore the hypothesis for the current study was that cow's milk in sensitized infants may impair antral motility, thereby promoting GER and reflex vomiting. Methods: Seven vomiting infants with CMPA and nine with primary GER underwent a challenge with cow's milk formula. Electrogastrography (EGG) was used to measure the spectral frequency (bradygastria = 1.5-2.4 cycles per minute [cpm], normogastria = 2.5-3.9 cpm, tachygastria = 4.0-9.0 cpm) and the postprandial-to-fasting power ratio of gastric electrical activity, whereas gastric half-emptying time (T1/2) was measured by electrical impedance tomography (EIT). Results: In CMPA and GER, respectively, during fasting, the frequency distribution (mean ± SD) of the EGG was as follows: normogastria 47.9% ± 12.5% versus 52.2% ± 9.8%, bradygastria 24.1% ± 5.7% versus 22.8% ± 8.3%, and tachygastria 28.0% ± 8.5% versus 25.0% ± 8.3%. In contrast, after the cow's milk challenge, the difference between the two groups was statistically significant: normogastria 33.1% ± 8.8% versus 70.6% ± 8.6% (P <0.0001), bradygastria 38.0% ± 15.5% versus 15.7% ± 5.2% (P = 0.002), and tachygastria 28.9% ± 10.6% versus 13.4% ± 4.6% (P = 0.001. The postprandial/fasting power ratio (mean ± SD) was 3.2 ± 1.9 in CMPA and 8.1 ± 2.1 in GER (P <0.0001). Gastric T1/2 (mean ± SD) of the cow's milk meal was 89.0 ± 26.3 minutes versus 54.0 ± 12.6 minutes (P = 0.003). In infants with GER all EGG parameters and gastric T1/2 were similar to that in 10 healthy control infants. Conclusions: In sensitized infants, cow's milk induces severe gastric dysrhythmia and delayed gastric emptying, which in turn may exacerbate GER and induce reflex vomiting. Electrogastrography and EIT can be useful in the assessment of vomiting, GER, and CMPA in infants.
AB - Background: Regurgitation and vomiting are common manifestations of cow's milk protein allergy (CMPA) in infants and are usually ascribed to gastroesophageal reflux (GER). Gastric anaphylaxis can induce antral dysmotility in the rat, and therefore the hypothesis for the current study was that cow's milk in sensitized infants may impair antral motility, thereby promoting GER and reflex vomiting. Methods: Seven vomiting infants with CMPA and nine with primary GER underwent a challenge with cow's milk formula. Electrogastrography (EGG) was used to measure the spectral frequency (bradygastria = 1.5-2.4 cycles per minute [cpm], normogastria = 2.5-3.9 cpm, tachygastria = 4.0-9.0 cpm) and the postprandial-to-fasting power ratio of gastric electrical activity, whereas gastric half-emptying time (T1/2) was measured by electrical impedance tomography (EIT). Results: In CMPA and GER, respectively, during fasting, the frequency distribution (mean ± SD) of the EGG was as follows: normogastria 47.9% ± 12.5% versus 52.2% ± 9.8%, bradygastria 24.1% ± 5.7% versus 22.8% ± 8.3%, and tachygastria 28.0% ± 8.5% versus 25.0% ± 8.3%. In contrast, after the cow's milk challenge, the difference between the two groups was statistically significant: normogastria 33.1% ± 8.8% versus 70.6% ± 8.6% (P <0.0001), bradygastria 38.0% ± 15.5% versus 15.7% ± 5.2% (P = 0.002), and tachygastria 28.9% ± 10.6% versus 13.4% ± 4.6% (P = 0.001. The postprandial/fasting power ratio (mean ± SD) was 3.2 ± 1.9 in CMPA and 8.1 ± 2.1 in GER (P <0.0001). Gastric T1/2 (mean ± SD) of the cow's milk meal was 89.0 ± 26.3 minutes versus 54.0 ± 12.6 minutes (P = 0.003). In infants with GER all EGG parameters and gastric T1/2 were similar to that in 10 healthy control infants. Conclusions: In sensitized infants, cow's milk induces severe gastric dysrhythmia and delayed gastric emptying, which in turn may exacerbate GER and induce reflex vomiting. Electrogastrography and EIT can be useful in the assessment of vomiting, GER, and CMPA in infants.
KW - Cow's milk protein allergy
KW - Electrical impedance tomography
KW - Electrogastrography
KW - Gastroesophageal reflux
KW - Vomiting
UR - http://www.scopus.com/inward/record.url?scp=0035148460&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035148460&partnerID=8YFLogxK
U2 - 10.1097/00005176-200101000-00017
DO - 10.1097/00005176-200101000-00017
M3 - Article
C2 - 11176327
AN - SCOPUS:0035148460
VL - 32
SP - 59
EP - 64
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
SN - 0277-2116
IS - 1
ER -