Allergic colitis history and symptoms: Difference between revisions
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{{Allergic colitis}} | {{Allergic colitis}} | ||
{{CMG}}; {{AE}}{{QS}} | {{CMG}}; {{AE}}{{QS}} | ||
==Overview== | ==Overview== | ||
The most common symptoms of allergic colitis is passage of blood streaked stool in an otherwise healthy young infant especially in FPIAP. History of failure to thrive may also be gotten in the infant with FPIES. There may be a family history of allergy. | The most common symptoms of allergic colitis is passage of blood streaked stool in an otherwise healthy young infant especially in FPIAP. History of [[failure to thrive]] may also be gotten in the infant with FPIES. There may be a family history of [[allergy]]. | ||
==History and Symptoms== | ==History and Symptoms== | ||
| Line 15: | Line 16: | ||
*Is the child thriving or ill looking | *Is the child thriving or ill looking | ||
*Presence of abdominal pain | *Presence of abdominal pain | ||
* | *Family history of [[allergy]] | ||
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! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Type of Allergic colitis}} | ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Type of Allergic colitis}} | ||
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|History and Symptoms}} | ! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|History and Symptoms}} | ||
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! style="padding: 5px 5px; background: #DCDCDC; | ! rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" | '''[[Food protein-induced allergic proctocolitis]]'''<ref name="pmid24416045">{{cite journal| author=Hwang JB, Hong J| title=Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates? | journal=Korean J Pediatr | year= 2013 | volume= 56 | issue= 12 | pages= 514-8 | pmid=24416045 | doi=10.3345/kjp.2013.56.12.514 | pmc=3885785 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24416045 }} </ref><ref name="pmid11264489">{{cite journal| author=Pumberger W, Pomberger G, Geissler W| title=Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood. | journal=Postgrad Med J | year= 2001 | volume= 77 | issue= 906 | pages= 252-4 | pmid=11264489 | doi= | pmc=1741985 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11264489 }} </ref><ref name="pmid21762530">{{cite journal| author=Lucarelli S, Di Nardo G, Lastrucci G, D'Alfonso Y, Marcheggiano A, Federici T et al.| title=Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation. | journal=BMC Gastroenterol | year= 2011 | volume= 11 | issue= | pages= 82 | pmid=21762530 | doi=10.1186/1471-230X-11-82 | pmc=3224143 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21762530 }} </ref><ref name="pmid25976434">{{cite journal| author=Nowak-Węgrzyn A| title=Food protein-induced enterocolitis syndrome and allergic proctocolitis. | journal=Allergy Asthma Proc | year= 2015 | volume= 36 | issue= 3 | pages= 172-84 | pmid=25976434 | doi=10.2500/aap.2015.36.3811 | pmc=4405595 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25976434 }} </ref> | ||
| style="padding: 5px 5px; background: #F5F5F5; | | rowspan="1" style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Onset of symptoms is usually insidious in the first weeks to two months of life. This is modified by amount and duration of exposure to the offending protein | *Onset of symptoms is usually insidious in the first weeks to two months of life. This is modified by amount and duration of exposure to the offending protein | ||
*Child is on exclusive breastfeeding | *Child is on exclusive breastfeeding | ||
*History of passage blood streaked stool, which is loose or may be of normal consistency | *History of passage blood streaked stool, which is loose or may be of normal consistency | ||
*Despite passage of loose stools, there is typically no history of frank diarrhea | *Despite passage of loose stools, there is typically no history of frank [[diarrhea]] | ||
*History of occasional episode of vomiting | *History of occasional episode of [[vomiting]] | ||
*History of abdominal pain or discomfort when defecating may be present | *History of [[abdominal pain]] or discomfort when defecating may be present | ||
*History of atopy in the family | *History of [[atopy]] in the family | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC; | ! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" | '''[[Food protein-induced enterocolitis syndrome]]'''<ref name="pmid25976434">{{cite journal| author=Nowak-Węgrzyn A| title=Food protein-induced enterocolitis syndrome and allergic proctocolitis. | journal=Allergy Asthma Proc | year= 2015 | volume= 36 | issue= 3 | pages= 172-84 | pmid=25976434 | doi=10.2500/aap.2015.36.3811 | pmc=4405595 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25976434 }} </ref><ref name="pmid24739227">{{Cite journal | ||
| style="padding: 5px 5px; background: #F5F5F5; | | author = [[Alessandro Fiocchi]], [[Alessia Claps]], [[Lamia Dahdah]], [[Giulia Brindisi]], [[Carlo Dionisi-Vici]] & [[Alberto Martelli]] | ||
Typical presentation is that of chronic exposure with onset of symptoms developing insidiously in the first few weeks of life to as long as 1 year | | title = Differential diagnosis of food protein-induced enterocolitis syndrome | ||
*Recurrent vomiting that may initially be | | journal = [[Current opinion in allergy and clinical immunology]] | ||
*Child is usually on infant formula only but occasionally infant formula with breastfeeding | | volume = 14 | ||
*Infant formula is usually cow's milk or soy milk based formula | | issue = 3 | ||
| pages = 246–254 | |||
| year = 2014 | |||
| month = June | |||
| doi = 10.1097/ACI.0000000000000057 | |||
| pmid = 24739227 | |||
}}</ref> | |||
| rowspan="1" style="padding: 5px 5px; background: #F5F5F5;" |'''Chronic''' | |||
Typical presentation is that of chronic exposure to the trigger food with onset of symptoms developing insidiously in the first few weeks of life to as long as 1 year. | |||
*Recurrent vomiting that may initially be unrelated to food intake | |||
*Child is usually on [[infant formula]] only but occasionally [[infant formula]] with [[breastfeeding]] | |||
*[[Infant formula]] is usually cow's milk or [[soy milk]] based formula | |||
*History of recurrent episodes of vomiting few hours after ingestion of food | *History of recurrent episodes of vomiting few hours after ingestion of food | ||
*History of diarrhea, which is blood stained | *History of [[diarrhea]], which is blood stained | ||
*Occasionally diarrhea stool may be completely bloody | *Occasionally diarrhea stool may be completely bloody | ||
*History of child losing weight or having poor weight gain | *History of child losing weight or having [[Failure to thrive|poor weight gain]] | ||
*History of atopy in the family | *History of [[atopy]] in the family | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5; | | rowspan="1" style="padding: 5px 5px; background: #F5F5F5;" |'''Acute''' | ||
Symptoms occur with a background chronic exposure | Symptoms occur following a period of avoidance of trigger food in a patient with a background history of chronic exposure. It may also follow intermittent exposures. Acute manifestation is seen in about 20% of patients with FPIES | ||
*History of recurrent episodes of vomiting few hours (1 to 3 hours) after taking the offending | *History of dramatic recurrent episodes of vomiting few hours (1 to 3 hours) after taking the offending food | ||
*Vomiting is usually of large volume, may be projectile and bilious | *Vomiting is usually of large volume, may be projectile and [[bilious]] | ||
*History of passage of diarrhea stool occurring | *History of passage of [[diarrhea]] stool occurring shortly after the onset of [[vomiting]]. [[Diarrhea]] stool is usually of large volume and may or may not contain streaks of blood and mucus | ||
*Occasionally diarrhea stool may become completely bloody | *Occasionally diarrhea stool may become completely bloody | ||
*History of atopy in the family | *History of [[atopy]] in the family | ||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 16:17, 1 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]
Overview
The most common symptoms of allergic colitis is passage of blood streaked stool in an otherwise healthy young infant especially in FPIAP. History of failure to thrive may also be gotten in the infant with FPIES. There may be a family history of allergy.
History and Symptoms
Obtaining a detailed history is important in making diagnosis of allergic colitis. Complete history will help determine the cause and possible risk factors associated with the disease.
History
Specific history to ask include:
- When the symptoms started
- Type of food ingested
- Detailed description of the symptoms, such as stool pattern, number of times and presence or absence of blood in the stool; and vomiting
- Is the child thriving or ill looking
- Presence of abdominal pain
- Family history of allergy
| Type of Allergic colitis | History and Symptoms |
|---|---|
| Food protein-induced allergic proctocolitis[1][2][3][4] |
|
| Food protein-induced enterocolitis syndrome[4][5] | Chronic
Typical presentation is that of chronic exposure to the trigger food with onset of symptoms developing insidiously in the first few weeks of life to as long as 1 year.
|
| Acute
Symptoms occur following a period of avoidance of trigger food in a patient with a background history of chronic exposure. It may also follow intermittent exposures. Acute manifestation is seen in about 20% of patients with FPIES
|
References
- ↑ Hwang JB, Hong J (2013). "Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?". Korean J Pediatr. 56 (12): 514–8. doi:10.3345/kjp.2013.56.12.514. PMC 3885785. PMID 24416045.
- ↑ Pumberger W, Pomberger G, Geissler W (2001). "Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood". Postgrad Med J. 77 (906): 252–4. PMC 1741985. PMID 11264489.
- ↑ Lucarelli S, Di Nardo G, Lastrucci G, D'Alfonso Y, Marcheggiano A, Federici T; et al. (2011). "Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation". BMC Gastroenterol. 11: 82. doi:10.1186/1471-230X-11-82. PMC 3224143. PMID 21762530.
- ↑ 4.0 4.1 Nowak-Węgrzyn A (2015). "Food protein-induced enterocolitis syndrome and allergic proctocolitis". Allergy Asthma Proc. 36 (3): 172–84. doi:10.2500/aap.2015.36.3811. PMC 4405595. PMID 25976434.
- ↑ Alessandro Fiocchi, Alessia Claps, Lamia Dahdah, Giulia Brindisi, Carlo Dionisi-Vici & Alberto Martelli (2014). "Differential diagnosis of food protein-induced enterocolitis syndrome". Current opinion in allergy and clinical immunology. 14 (3): 246–254. doi:10.1097/ACI.0000000000000057. PMID 24739227. Unknown parameter
|month=ignored (help)