Allergic colitis history and symptoms

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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
• Is there any family history of allergy

Type of Allergic colitis	History and Symptoms
Food protein-induced allergic proctocolitis	History of onset of symptoms in the first two months of life. This is modified by amount and duration of exposure to the offending protein Child is on exclusive breastfeeding 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 History of occasional episode of vomiting History of abdominal pain or discomfort when defecating may be present History of atopy in the family
Food protein-induced enterocolitis syndrome	Chronic Typical presentation is that of chronic exposure with onset in the first few weeks of life to as long as 1 year Recurrent vomiting that may initially be difficult to relate 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 diarrhea, which is blood stained Occasionally diarrhea stool may be completely bloody History of child losing weight or having poor weight gain History of atopy in the family
	Acute Symptoms occur with a background chronic exposure History of recurrent episodes of vomiting few hours (1 to 3 hours) after taking the offending feed Vomiting is often large, may or may not be bilious and may be described as projectile History of passage of diarrhea stool occuring soon after the onset of vomiting. Diarrhea stool may or may not contain streaks of blood and mucus Occasionally diarrhea stool may become completely bloody History of atopy in the family