Cow's milk-related symptom score (CoMiSS): from Bristol to Brussels Stool Scale.

Data de publicació: 06/09/2023 Data Ahead of Print: 06/09/2023

Autors de IIS La Fe

• 

  Carmen Ribes Koninckx

  Autor

Autors aliens a IIS La Fe

• Bajerova, Katerina
• Salvatore, Silvia
• Dupont, Christophe
• Kuitunen, Mikael
• Meyer, Rosan
• Shamir, Raanan
• Szajewska, Hania
• Staiano, Annamaria
• Vandenplas, Yvan

Grups d'Investigació

• Enfermedad celíaca e Inmunopatología digestiva

  

  Investigador Principal

  Carmen Ribes Koninckx

• Unidad Mixta De Investigación en Nutrición de Precisión para patologías digestivas (NUTRICURA PDig)

  

  Investigador Principal

  Carmen Ribes Koninckx

Abstract

OBJECTIVES: The Cow's Milk-related Symptom Score (CoMISS TM) is an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy infants <1 year of age. This study assessed whether replacing the Bristol Stool Form Scale (BSFS) with the Brussels Infants and Toddlers Stool Scale (BITSS) in non-toilet-trained infants would modify the overall CoMiSS and change the clinical approach regarding potential cow's milk allergy. METHODS: Non-toilet-trained infants aged <13 months were assessed by CoMiSS using the seven images from the BSFS (CoMiSS-BSFS) compared to the four images of stools from BITSS (CoMiSS-BITSS). The Wilcoxon Signed-Rank test and Pearson Correlation Coefficient were calculated. A post hoc analysis using identical tests was performed in subsets of CoMiSS-BSFS scores =10, =12, =5 and =6. RESULTS: 844 pairwise scores were collected. Applying the Wilcoxon test over the complete dataset, the difference between CoMiSS-BSFS and CoMiSS-BITSS was statistically significant (p<0.001). However, there was no significant difference in the subsets with CoMiSS-BSFS =10, =12 and =6 (p=0.84, p=0.48 and p=0.81, respectively). The significant difference remained restricted to the group with CoMiSS-BSFS =5, considered at low risk for CM-related symptoms (p<0.001). CONCLUSION: Replacing BSFS with BITSS does not change the cut-off for awareness of possible CM-related symptoms and will not impact the use of CoMiSS in clinical practice. Changes in CoMiSS remained limited to the subgroup with a low risk for CM-related symptoms.

Copyright © 2023 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Keywords

• Bristol Stool Scale; Brussels Infant and Toddlers Stool Scale; cow's milk related symptom score; infant; stool consistency