A Broad Introduction
Rhinitis & Hay Fever
Children & Infants
Allergy to Animals
The gut is obviously the most frequently involved organ system in
childhood, frequently recovering spontaneously after infancy, thus
obscuring and confusing the diagnosis of milk intolerance.
can be affected from one end to the other, from apthous ulcers or
oral allergy syndrome to proctitis or colitis. Diarrhoea is a common
presentation of intolerance in infancy which may damage the lining
of the gut leading to secondary lactase deficiency, malabsorption,
malnutrition, steatorrhoea (fatty, floating diarrhoea), failure to
thrive, occult bleeding and anaemia.
Rejection of a formula feed by
vomiting or by diarrhoea, or projectile vomiting which may be
misdiagnosed as pyloric stenosis, and may not recognised to be due
to milk. Reflux is well known as a trigger for
asthma and intractable cough in adults suggesting that foods may be
The Dairy Industry both here and in the USA promote milk
products vigorously for health. This may be true for the majority
but a minority suffer from the multiple effects of milk intolerance
which are probably seldom diagnosed.
What could cause diarrhoea every Saturday morning?
A fifty year old lady wanted to find out why she had had acute
diarrhoea every Saturday morning for twenty years for which she had
had many expensive and detailed investigations at a teaching
hospital. A careful history disclosed the answer, because it was her
custom after leaving work at noon on Saturday to purchase her weekly
treat. This was a cream bun she bought at the bakers and ate as she
was walking home. She would just get there in time before the
A tale from the Colonies with a bad smell
An atopic mother who had both her children when resident in the New
Hebrides Islands in the Pacific, breast fed her youngest son
successfully to eight months, but when transferred to milk formula
he responded with constant rhinitis, wheezing, eczema, and incessant
screaming. He thrived on a soya formula, and when seen aged two it
had become obvious that milk chocolate caused aggressiveness and
headaches, and carrots caused diarrhoea and vomiting. He had asthma
if he got the slightest trace of milk, and as time went by he began
to react to dogs and horses as well. By age seven he was able to
take some milk but he had chronic diarrhoea, which was aggravated by
a disguised milk drink, but avoidance of milk was ineffective this
time, and he had chronic abdominal pains.
His elder brother had also
developed chronic diarrhoea, and they both had very malodorous
stools which floated. Mother had concluded that males always had
very smelly motions because father had the same problem, so she did
not realise that this was abnormal !!. On a gluten free diet all
symptoms disappeared in a week in both children, and they both began
to grow very rapidly suggesting significant malabsorption had been
present. Unfortunately father was still in the New Hebrides, where
a gluten free regime was not possible.
The rapidity of recovery
suggested that the gluten intolerance was secondary to milk
intolerance, not true celiac disease. The asthma which still
affected the younger boy disappeared, and his problems with reading,
which had been firmly diagnosed as dyslexia, improved rapidly and
Another bad smell and misbehaviour
Christopher was five when he was referred with rhinitis and cough,
but also had a history of projectile vomiting which ceased as the
rhinitis and cough began.
He had constant wind and frequent colic,
his abdomen was bloated, and he passed only two very smelly motions
per week. He was very difficult to handle, resented being examined,
and all skin tests were negative.
Avoidance of milk resulted in
disappearance of all symptoms in a week and his behaviour became
normal. Mother commented that when she gave him test feeds of milk
as I had instructed in order to prove that milk was the cause his
behaviour became as foul as the smell of the huge stools which
ensued a few hours later on every occasion he had milk!
Milk, Mouth Ulcers, and Wheat Intolerance
Lisa was twenty-three when she was referred by a gastroenterologist
for skin tests. There was a significant family history again, as
both her parents had had a deficiency of lactase, without which they
cannot digest milk. As a baby she had had projectile vomiting, which
was diagnosed as hiatus hernia but was almost certainly milk
intolerance. From age six months to four years she was hyperactive
with behaviour problems and tantrums, followed by an incessant
cough, sputum, excessive nasal secretions, and frequent sinusitis,
probably caused by milk intolerance which did not recover
spontaneously as it
No doctor would believe that there was a problem in spite of many
consultations, so despairing of any help from conventional medicine
she was taken to a chiropractor who diagnosed lactose intolerance,
probably because of the family history. Avoidance of all diary
products resulted in disappearance of the cough and other symptoms,
and she was very much better except for the frequent mouth ulcers
which had also been a problem since infancy.
While at university her abdominal pains were diagnosed at a famous
Teaching Hospital as Irritable Bowel Syndrome (“IBS”) for which
she was given Fybogel which made it worse. When aged 22 she was seen
by a hospital dentist who suggested that the mouth ulcers could be a
sign of Coeliac disease, and by avoiding gluten completely all her
symptoms cleared up by the time the result of the blood test for
Coeliac disease was reported to be negative. This meant that she was
actually intolerant of wheat, rather than just gluten, as well as
milk. All skin and immunology tests were negative.
She commented that she had had more help from the chiropractor who
suggested milk intolerance and the dentist who suggested gluten
intolerance, than conventional doctors whom she had seen many times
over the years without obtaining either diagnosis or adequate
investigation… She remains very happy and healthy with no milk, no
wheat, and no medication.
Irritable Bowel Syndrome
not all in the mind?
The current medical opinion regarding IBS is that it is usually all
in the mind. Dr J O Hunter and colleagues in Cambridge have shown
clearly that normal amounts of foods, particularly milk and wheat,
will provoke symptoms of IBS in many cases.
Personal experience over
many years has confirmed his views that milk and wheat can cause
IBS, sometimes when the problem for which the patient had been
referred was asthma or chronic cough, and no attention had been paid
to the IBS. Milk sensitivity has recently
been described as the key to poorly defined gastrointestinal
symptoms in adults, confirming my experience. Before assuming that
IBS is all in the mind it would be worth while considering a trial
of a diet excluding milk, beef, and wheat to exclude these
Unfortunately Dr Hunter’s very careful researches over many years
have not been followed by many other gastro-enterologists, and the
prevailing opinion is that IBS is usually of emotional origin is the
received wisdom today.
Milk avoidance was shown by Andreasen in 1921 and Truelove in Oxford
in 1961 ago to be very helpful in ulcerative colitis, but the
evidence since then is inconclusive. Occasional personal experience
has been encouraging, and leads me to suggest that dietary
manipulation should be introduced as soon as possible as a first
approach. This is because after colitis has been present for some
time definite pathological changes must appear in the colon. These
changes may in time become permanent to the extent that no amount of
dietary manipulation could be expected to reverse them, so that
surgical removal of the colon eventually presents the only
possibility of a cure. I seldom see colitis cases, but again Dr John
Hunter has had success with dietary manipulation in Cambridge..
A difficult teenager with Ulcerative Colitis
A young lady of 18 who had had ulcerative colitis for three years,
confirmed by colonoscopy and biopsy and treated with salazopyrin and
steroid enemas, was seen in the hope of finding an avoidable cause.
There was a strong family history of allergy on her father’s side.
In infancy she had had problems in tolerating cow’s milk and had
soya formula, was wheezy and hyperactive, and had eczema. She had positive prick tests for dust mite, and had
chronic rhinitis due to dust mite. She was obviously very atopic, and
with milk avoidance her bowel function became normal in two months,
bleeding and anaemia ceased, and there was a very noticeable
decrease in the dreadful smell of her stools which was obvious to
the whole family.
Her personality changed for the better and she became more
cooperative, but she had a craving for milk products. The next
event was that she deliberately had a pizza with a cheese topping
which caused very malodorous stools next day, and then milk in her
coffee was followed by blood in the stools and the dreadful smell
the next day. She had such an addiction to milk that her personality
deteriorated and she became uncooperative. Attempts were made to
persuade her to try a wheat free diet as well because it seemed
likely that wheat was also causing of her colitis, but she would
not co-operate. She eventually left home to stay with the boy-friend
and the outcome is unknown.
Milk was clearly a major causative factor, but she was a very
awkward teenager who could not even remember to take her medication.
The anti-social smell of the stools which is a feature of these
cases suggests that changes in the gut flora may be triggered by
milk, and the smell can point to the diagnosis.
Beef can trigger Colitis
A forty five year old man who had severe ulcerative colitis heard
that milk could be a cause, put himself on a milk free diet, and
improved remarkably. Unfortunately he was very fond of steak, so he
ate a large rare steak to celebrate his improvement. From the next
day he had a severe flare-up and he finally had to have the colon
removed, probably because the disease had become irreversible
Constipation caused by Milk
Chronic constipation is an uncommon presentation of milk
intolerance, but scattered references are to be found in the
literature, and detailed studies have been carried out recently. The
authors suggested that “removing cow’s milk from as child’s diet
should be recommended as the first line of treatment before
administering large doses of laxatives”
A stool as big as a milk bottle !
The most striking example was a girl aged nine who had a history of
severe infant feeding difficulties, followed by chronic asthma, and
also constipation so severe that she usually passed a motion once in
about two weeks. The product was described as being the length and
diameter of a milk bottle (!), which had to be broken up to be
A paediatrician had insisted that all her problems were due to the
marital discord which had led to her mother’s divorce, but avoidance
of milk products not only resolved her asthma in a week but she also
passed normal stools daily for the first time since infancy,.
Re-introduction of milk repeatably reproduced both asthma and
Constipated from birth!
An eight year old girl had constipation from birth. This was
probably correct because it was clearly recalled that the newborn
formula fed baby did not pass a motion for three days after
delivery. She had been investigated in hospital for abdominal pains
on several occasions without a diagnosis being made, until her
mother read in a magazine that milk could cause constipation, and
she came for confirmation. Avoidance of all milk products and beef
abolished her pains and her constipation, and reintroduction either
by accident or on purpose reproduced pains and constipation.
Beef and beef extract can cause Asthma as well as Gut Problems
It makes sense that
beef, which is the source of milk, will cause problems and it is
difficult to understand why dietitians often do
not accept this obvious fact. There is no better example than the
peak flow charts after this patient consumed a nice steak. This
patient did not react to milk, so he had a specific response to some
protein which was present in beef but not in milk.
The other patient complained that every time he had a Bovril drink
at bedtime he had asthma in the night, and he was persuaded to prove
it, but these experiments are unacceptable as they were not carried
Why was the baby was better on the bus
The most striking case encountered where beef was important was a
baby whose constant screaming and incessant watery diarrhoea created
such a bad smell that the parents said that the house had become
almost uninhabitable. A hospital dietitian had put him on a
milk-free regime, but it was not beef free, and there was no
While waiting to be seen at the clinic, and in spite of these
anti-social problems, his parents took him with them on a bus tour
round Europe for two weeks! To everyone’s surprise and delight he
was perfectly well on the bus, and was spoiled by everybody, but on
return home he promptly relapsed his stinking diarrhoea.
There had to be some simple explanation for this remarkable case,
where most parents would not have gone on a bus tour because of this
anti-social problem. On close interrogation I discovered that they
had taken with them on the bus suitcases full of infant foods from a
different manufacturer. Enquiry revealed that these tins of baby
food did not have a beef broth base, while the foods he had been
given before the trip did.!
When beef was excluded by switching to
the make of food which he had had on the bus, his symptoms cleared
in a few days. Deliberate challenges with baby foods which contained
a beef broth base reproduced the diarrhoea every time. In other
cases less severe problems have been found to be due to beef fat
incorporated in soya formula, but I believe this has been removed.