TO THE EDITOR: In the March 1 2003 ...

TO THE EDITOR: In the March 1 2003 issue of American Family Physician, the department "Clinical Evidence" (1) addressed the weights of various treatments for childhood constipation. The author no other than briefly touches on the factor of dietary factors by the agency of stating that there are "no randomized controll trials in succession the effects of increasing dietary fiber in children."

In my experience, intolerance of cow's milk is a significant cause of childhood constipation. A popular pediatric textbook (2) lists excessive milk intake as a cause of constipation in children. A double-blind research (3) of 65 children with chronic constipation who failed to reply to laxatives showed resolution of the constipation in 66 percent of the exposes while on soy milk.

REFERENCES

(1) Rubin GP Childhood constipation. [Clin Evidence] Am Fam Physician 2003;67:1041-2

(2) Sondheimer JM Gastrointestinal tract. In: Hay WW generally received pediatric diagnosis & treatment. 15th ed Norwalk, Conn: Appleton & Lange, 2001:561

(3) Iacono G Cavataio F Montalto G Florena A, Tumminello M Soresi M et al. Intolerance of cow's milk and chronic constipation in children. N Engl J M 1998;339:1100-4

WILLIAM MORA, MD

3301 Alta Arden, Ste 3

Sacramento, CA 95825

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