Allergic colitis differential diagnosis

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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

Symptoms and signs of allergic colitis are non-specific and seen in other causes of colitis and some systemic diseases. Endoscopy with biopsy is often needed in addition to detailed history and physical examination to make the diagnosis. In infancy, allergic colitis must particularly be differentiated from necrotizing enterocolitis, infectious colitis, anal fissure, intussusception and volvolus. In adolescent and adults, allergic colitis must be differentiated from inflammatory bowel disease, infectious colitis, and colorectal malignancy.

Differential Diagnosis

The differential diagnosis of allergic colitis can be classified into two according to age group.

Differential diagnosis in Infants

• Swallowed maternal blood syndrome
• Anorectal fissure
• Necrotizing enterocolitis especially in preterm babies
• Vitamin K dependent hemorrhage
• Other Coagulopathies (hereditary such as coagulation factor deficiency or acquired such as Liver disease with clotting factor deficiency)
• Intussusception
• Infectious colitis
• Meckel diverticulum
• Gastrointestinal duplication cyst
• Vascular malformations
• Inflammatory bowel disease(early onset)
• Hirschsprung disease complicated by enterocolitis
• Volvolus
• Gastro-duodenal ulcers
• Lymphonodular hyperplasia

Differential diagnosis in adolescent/ adult

• Crohn's disease
• Behcet's disease
• Arteriovenous malformation
• Diverticuclosis
• Infectious colitis
• Coagulopathy
• Henoch-Schonlein purpura
• Systemic lupus erythematosus(SLE)
• Colorectal malignancy