Allergic colitis natural history, complications and prognosis

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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

Allergic colitis typically develops in early infancy. Allergic colitis is benign, resolving completely in most children without any sequelae. The infants with food protein-induced allergic proctocolitis are usually on exclusive breastfeeding while those with food protein-induced enterocolitis syndrome are often on infant formula. If left untreated, spontaneous resolution may occur in 20% of the children with allergic colitis without elimination of the triggering food. Most infants with allergic colitis will tolerate the offending food by 1 to 3 years of age.

Natural History, Complications, and Prognosis

Natural History

  • The natural history of allergic colitis that develops in adolescence or early adulthood especially if due to solid food is poorly characterized with the resolution of symptoms often prolonged.[5]

Complications

Complications of allergic colitis are more common with food protein-induced enterocolitis syndrome (FPIES) than food protein-induced allergic proctocolitis (FPIAP). The complications include:[6][7]

Prognosis

  • The prognosis of allergic colitis is excellent when it presents in infancy.
  • The disease is benign, self-limiting, and resolves completely, with the child outgrowing the allergy with age.
  • The prognosis for allergic colitis that presents in adolescence or adulthood is not fully understood.[1][3][6]

References

  1. 1.0 1.1 Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA; et al. (2010). "Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report". J Allergy Clin Immunol. 126 (6): 1105–18. doi:10.1016/j.jaci.2010.10.008. PMC 4241958. PMID 21134568.
  2. 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.
  3. 3.0 3.1 Koletzko S, Niggemann B, Arato A, Dias JA, Heuschkel R, Husby S; et al. (2012). "Diagnostic approach and management of cow's-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines". J Pediatr Gastroenterol Nutr. 55 (2): 221–9. doi:10.1097/MPG.0b013e31825c9482. PMID 22569527.
  4. 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.
  5. Alfadda AA, Storr MA, Shaffer EA (2011). "Eosinophilic colitis: epidemiology, clinical features, and current management". Therap Adv Gastroenterol. 4 (5): 301–9. doi:10.1177/1756283X10392443. PMC 3165205. PMID 21922029.
  6. 6.0 6.1 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.
  7. Jenkins HR, Pincott JR, Soothill JF, Milla PJ, Harries JT (1984). "Food allergy: the major cause of infantile colitis". Arch Dis Child. 59 (4): 326–9. PMC 1628682. PMID 6721558.

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