Symtoms, Diagnosis and Treatment of Cow Milk Allergy related Diarrhea

Diarrhea is a major symptom of cow milk allergy reactions, either immediate (within minutes from the intake of small quantities of cow milk) and delayed (several hours or even days after the intake of large quantities of cow milk). 
But diarrhea may have also other causes, may be accomplished by other symtoms and, especially in babies, should be treated promptly to avoid dehydratation risks. 
Diet of a baby with diarrhea should avoid, other that the allergenic food (i.e. the cow milk), also several foods can make diarrhea worse, preferring other foods that are usually are well tolerated.

Symptoms of diarrhea

The first indication is the duration: acute diarrhea usually lasts 1 or 2 days, going away on its own, prolonged diarrhea persists longer, for more than 2 days.

People who have diarrhea may also have:

• crampy pain in the abdomen, the area between the chest and the hips
• swelling in the abdomen
• an uncomfortable feeling around the anus
• an urgent need to have a bowel movement
• an inability to control their bowels (fecal incontinence)
• chills
• fever

Diarrhea may also be preceded by other symptoms, as nausea, vomiting, fever or bloody stools, typical symtoms of cow milk allergy.

In children, diarrhea can quickly lead to dehydration. Particular signs of deydratation include:

• dry mouth and tongue
• no tears when crying
• no wet diapers for 3 hours or more
• sunken abdomen, eyes, or cheeks
• high fever
• listlessness or irritability
• skin that does not flatten when pinched and released

If your child does not improve after 24 hours or has any of the following symptoms along with diarrhea, call the doctor. This is especially important if your child is 6 months old or younger.

To find out if cow milk allergy, other food allergies or food intolerances are causing the diarrhea, the doctor may ask you to change your child diet, avoiding cow milk, lactose or other common allergenic foods, to see whether the diarrhea diminish and stops.

To exclude other causes, the doctor could ask for stool culture, to check for bacteria, parasites, or other signs of disease and infection, for blood tests and for other examinations, that can be helpful in ruling out certain diseases.

Treatment of cow milk allergy related diarrhea
Treatment is directed largely towards management of underlying cause. In cow milk allergy, dietary modification is the essential treatment, to stop the colon inflammation and to allow liquid absorption.

Until the recovery, it is also important to replace fluids that are lost with the stools, to prevent dehydration: adults should consume broth, soup, fruit juices, soft fruits, or vegetables and children should drink special liquids that has all the nutrients they need.

Your paediatrician may also prescribe you some medications that help reducing diarrhea causes. Some of them may include:

• absorbents, compounds that absorb water in the small intestine and colon and make diarrheal stools less watery
• anti-motility medications, which relax the muscles of the small intestine and/or the colon, resulting in slower flow of intestinal contents and, consequently, allowing more time for water to be absorbed from the intestine and colon and reducing the water content of stool. Cramps, due to spasm of the intestinal muscles, also are relieved by the muscular relaxation.

Tips about Food
Until diarrhea subsides, your child diet should avoid foods that are greasy, high in fiber, or very sweet, that can make it worse. In particular, it’s better to avoid:

• cow milk and dairy products, such as ice cream or cheese (cow milk products are laxative also for not allergic people)
• high-fat or greasy foods, such as fried foods
• foods that have a lot of fiber, such as citrus fruits
• very sweet foods, such as cakes and cookies

Foods that usually are well tolerated during a diarrheal illness include rice, cereal, bananas, potatoes, and lactose free products. As your baby improves, you can add soft, bland foods to your child’s diet, including bananas, plain rice, boiled potatoes, toast, crackers and cooked carrots.

Once the diarrhea has stopped and the allergenic food has been identified, the cow milk in case of cow milk allergy, the paediatrician will likely encourage your child to return to a normal and healthy diet, only excluding the food.

Source:

National Digestive Diseases Information Clearinghouse

The Mayo Clinic