What are the signs of allergic colitis in babies. How is allergic colitis diagnosed and treated. What causes allergic colitis in infants. How can parents recognize allergic colitis symptoms. When should you see a doctor for suspected allergic colitis. What dietary changes help manage allergic colitis. How long does it take for allergic colitis to improve with treatment.

Understanding Allergic Colitis: A Common Condition in Infants

Allergic colitis is a condition that affects approximately 2-3% of infants, causing inflammation in the colon due to an overreaction of the immune system to certain proteins, primarily those found in cow’s milk. This condition can be concerning for parents, but understanding its nature, symptoms, and treatment options can help alleviate worries and ensure proper care for affected babies.

Is allergic colitis a serious condition? While it can cause discomfort for infants, allergic colitis is generally not severe and is often temporary. However, it’s essential to address the condition to ensure proper nutrition and comfort for the baby.

Recognizing the Signs: Key Symptoms of Allergic Colitis

Identifying allergic colitis in infants can be challenging, as symptoms may vary in severity and onset. Most babies exhibit signs within the first two months of life, although symptoms may not appear until six months of age in some cases.

• Extreme fussiness and irritability
• Difficulty consoling the baby
• Blood or mucus in stools (often appearing as flecks or streaks)
• Diarrhea and vomiting (in some cases)
• Nasal congestion or eczema (as signs of other allergies)
• Gassiness and abdominal discomfort
• Poor weight gain or difficulty feeding
• Increased reflux or spitting up

Can allergic colitis symptoms vary in severity? Indeed, the condition falls on a spectrum, with some babies experiencing mild symptoms while others may have more severe reactions to milk proteins.

The Root Cause: Understanding Allergic Colitis Triggers

Allergic colitis seems to result from a combination of factors, including changes in the mother’s immune system during pregnancy and the immaturity of the baby’s immune system. While the exact cause remains unclear, certain risk factors have been identified.

Risk Factors for Allergic Colitis

• Family history of food allergies
• Asthma in family members
• Environmental allergies in the family
• Genetic predisposition

Does having a family history of allergies guarantee that a baby will develop allergic colitis? While it increases the risk, not all babies with a family history of allergies will develop the condition.

Diagnosis Process: Identifying Allergic Colitis in Infants

If you suspect your baby may have allergic colitis, it’s crucial to consult a pediatrician. The diagnostic process typically involves the following steps:

1. Clinical evaluation of symptoms
2. Examination of the baby’s stool for blood (visible or microscopic)
3. Review of family medical history
4. Elimination diet trials (if breastfeeding)
5. Additional tests to rule out other conditions (if necessary)

Are there specific tests for diagnosing allergic colitis? While there’s no single definitive test, the presence of blood in the stool, combined with other symptoms and a positive response to dietary changes, usually confirms the diagnosis.

Treatment Approaches: Managing Allergic Colitis Effectively

The primary treatment for allergic colitis involves dietary modifications. The approach may differ depending on whether the baby is breastfed or formula-fed.

For Breastfed Babies:

• Mother eliminates dairy products from her diet
• Avoidance of soy products (if symptoms persist)
• Temporary use of hypoallergenic formula during transition

For Formula-Fed Babies:

• Switch to a hypoallergenic or extensively hydrolyzed formula
• Avoid soy-based formulas (as 30% of cow’s milk-allergic babies may also react to soy)

How long does it take to see improvements after dietary changes? It can take up to 72 hours for a mother’s breast milk to become free of milk proteins. Improvements in the baby’s symptoms may be noticeable within a few days, but it may take 3-4 weeks for the intestines to heal completely.

The Healing Process: What to Expect During Recovery

As parents implement dietary changes, it’s important to understand the recovery timeline and what to look for as signs of improvement.

• Reduction in irritability and fussiness
• Improved feeding and weight gain
• Gradual decrease in blood in stools
• Less gassiness and abdominal discomfort
• Improved sleep patterns

Is it normal to still see blood in the stool after starting treatment? Yes, it’s common to notice blood in the stool for 3-4 weeks after starting a milk/soy-free diet, as the intestines need time to heal.

Long-Term Outlook: Prognosis and Future Considerations

Allergic colitis is typically a temporary condition that resolves as the baby’s immune system matures. Most infants outgrow the allergy by their first birthday, although some may take longer.

Follow-up Care and Monitoring

• Regular check-ups with the pediatrician
• Gradual reintroduction of dairy under medical supervision
• Monitoring for other food allergies or sensitivities
• Nutritional guidance to ensure proper growth and development

Does having allergic colitis as an infant increase the risk of other allergies later in life? While it may indicate a predisposition to allergies, many children with allergic colitis do not develop other significant allergies as they grow older.

Supporting Your Baby: Tips for Parents Dealing with Allergic Colitis

Caring for a baby with allergic colitis can be challenging, but there are several ways parents can support their infant’s health and comfort:

• Maintain a detailed food diary if breastfeeding
• Learn to read food labels carefully to avoid hidden dairy or soy ingredients
• Seek support from lactation consultants or dietitians for dietary guidance
• Use gentle, fragrance-free products for baby’s skin to avoid irritation
• Practice stress-reduction techniques to stay calm during fussy periods
• Join support groups or connect with other parents dealing with allergic colitis

How can parents ensure they’re getting enough calcium while avoiding dairy? Consult with a dietitian to identify non-dairy calcium sources such as leafy greens, fortified plant-based milk, and supplements if necessary.

Emotional Support for Parents

Dealing with a baby’s health concerns can be emotionally taxing. It’s important for parents to:

• Communicate openly with healthcare providers about concerns and questions
• Seek emotional support from family, friends, or professional counselors
• Remember that allergic colitis is temporary and manageable
• Celebrate small improvements and milestones in the baby’s health

Caring for a baby with allergic colitis requires patience and dedication, but with proper management and support, most infants overcome this condition and thrive. By staying informed, working closely with healthcare providers, and maintaining a positive outlook, parents can navigate this challenging period and ensure the best possible outcome for their little ones.

As research in pediatric gastroenterology continues to advance, our understanding of allergic colitis and its management improves. Institutions like Boston Children’s Hospital’s Division of Gastroenterology, Hepatology and Nutrition, with over 65 years of experience in treating pediatric GI conditions, continue to lead the way in providing cutting-edge care for infants with allergic colitis.

Parents should remain vigilant but optimistic, knowing that with proper care and attention, their baby can overcome allergic colitis and go on to enjoy a healthy, happy childhood. The key lies in early recognition, prompt treatment, and consistent follow-up care, all while providing a nurturing and supportive environment for the infant to heal and grow.

Allergic Colitis | Boston Children’s Hospital

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Allergic colitis is a condition in which your baby’s immune system overreacts to the proteins found in cow’s milk, leading to inflammation in the colon.

Babies differ in how sensitive they are to milk. Some have very few symptoms, and others might experience blood in the stools if a breast-feeding mother has even a small splash of milk in her morning coffee.

Allergic colitis isn’t uncommon; it affects between 2 and 3 percent of infants. Babies from families with a history of food allergies, asthma, or environmental allergies seem to have a slightly higher risk of developing the condition.

Allergic colitis often has few symptoms, but may be associated with irritability, gassiness, and with blood or mucus in the stools can make eating very uncomfortable for a baby, so they may not get the nutrition they need.

Allergic Colitis | Symptoms & Causes

What are the symptoms of allergic colitis?

While symptoms may not appear until a baby turns 6 months old, most babies show signs within the first two months of life. In most babies, the symptoms are mild, but occasionally may worsen.

A baby with allergic colitis may be extremely fussy, difficult to console, and develop flecks or streaks of blood in the stool. Some infants also have diarrhea and vomiting, and some may show other signs of allergies, such as nasal congestion or eczema. It’s important to remember that allergic colitis falls on a spectrum — some babies are much more sensitive to milk protein (and have more severe symptoms) than others.

Many babies go through a period of reflux (spitting up food) in the first year of life, but babies with allergic colitis may have an especially hard time with reflux. Treating the colitis may lead to an improvement in the reflux, but some of the reflux maybe not be related to the allergy process.

What are the causes of allergic colitis?

Allergic colitis seems to be caused by a combination of changes to the mother’s immune system during pregnancy and the immaturity of a baby’s own immune system. But it’s not yet known why some babies develop the condition and others don’t.

There may be a hereditary component, since babies who come from families with a history of food allergies, asthma, or environmental allergies seem to be more likely to have allergic colitis.

Allergic Colitis | Diagnosis & Treatments

How is allergic colitis diagnosed?

If your baby is extremely irritable and you notice vomiting and gassiness, it’s a good idea to make an appointment to see a pediatrician. The doctor will check for blood in your baby’s stool. This might be blood that can only be seen through a microscope. If blood is found, the symptoms are most likely caused by an allergic reaction.

What are the treatment options for allergic colitis?

Most of the time, when an infant has blood in the stool, it’s caused by a milk allergy, which is very treatable. The mother is placed on a dairy-free diet (if she’s breast-feeding) or the baby is switched to a hypoallergenic formula. It takes up to 72 hours for the mother’s breast milk to become free of milk protein, so until you’re ready to nurse again, your baby will be given a hypoallergenic formula.

Roughly 30 percent of babies who are allergic to cow’s milk protein are also allergic to soy protein, so if your baby’s symptoms don’t clear up, it is recommended that a nursing mother avoid soy as well as dairy (or use a soy-free formula).

Keep in mind, even if your baby is no longer ingesting the proteins that are causing reactions in the intestine, the intestines still need to heal. That’s why you may continue to notice blood in the stool for three to four weeks after starting a milk/soy-free diet. But you should notice that your infant seems to be feeling better — less irritable and less reluctant to feed and also may be putting on weight, which is a good sign.

How we care for allergic colitis

The Boston Children’s Hospital Division of Gastroenterology, Hepatology and Nutrition has been treating children with GI conditions, like allergic colitis, for more than 65 years.

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How to Recognize Allergic Colitis in Infants

It’s temporary, but that’s hardly reassuring to new parents. Allergic colitis is a condition in which an infant’s immune system overreacts to the proteins found in cow’s milk (and sometimes soy), leading to inflammation, and sometimes tiny breaks, in the colon.

How might an infant be exposed to cow’s milk? Some breastfeeding moms drink it, and some baby formulas contain it.

Babies differ in how sensitive they are to milk proteins. Some have very few symptoms, and others might experience blood in the stools if a nursing mother adds even a splash of milk to her coffee, according to Boston Children’s Hospital.

Allergic colitis isn’t common — it’s thought to affect between 2 and 3 percent of infants.

Why some babies develop the condition and others don’t is not fully understood. However, allergic colitis is thought to be caused by a combination of changes to the mother’s immune system during pregnancy, and the immaturity of a baby’s own immune system.

Heredity may play a role as well. Infants born into families with a history of food allergies, asthma, or environmental allergies seem to have a slightly higher risk of developing the condition.

The good news is that symptoms of allergic colitis usually disappear once the condition is detected and the offending food is removed from the baby’s diet.

In addition, most infants become tolerant to milk proteins once milk is gradually reintroduced after age 1, according to a review article published in October 2020 in the World Allergy Organization Journal.

Knowing the Signs of Allergic Colitis

Most babies with allergic colitis will show some signs of the condition within the first two months of life, but some may not exhibit symptoms until they turn 6 months old.

A baby with allergic colitis may be extremely fussy, difficult to console, and develop flecks or streaks of blood in the stool. Some infants also have diarrhea and vomiting, and some may show other signs of allergies, such as nasal congestion or eczema.

But the symptoms of allergic colitis aren’t always this obvious. Many babies with this condition look and act healthy and some have normal-looking bowel movements — blood and mucous can be invisible to the naked eye.

As symptoms get worse, however, you’ll likely realize there’s a digestion problem. Allergic colitis can make eating uncomfortable for a baby. The resulting weight loss and protein loss will cause your baby a lot of distress.

As soon as you’re aware that something’s wrong, call your pediatrician. Your doctor will let you know if you need to see a specialist.

Once detected, allergic colitis is usually resolved relatively quickly, reassures Elizabeth Marcus, MD, a pediatric gastroenterologist and an assistant professor of pediatrics at The David Geffen School of Medicine at UCLA in Los Angeles.

She advises parents to know the signs of allergy, but not to change an infant’s diet without first consulting a pediatrician or pediatric gastroenterologist.

How Allergic Colitis Is Diagnosed

There isn’t a single test that spots allergic colitis. Your doctor will likely examine your baby, take a history, and run a test to check for blood in your baby’s stool. This might be blood that can only be seen through a microscope or detected with biochemical tests.

A diagnosis of allergic colitis is often not made, however, until the implementation of an allergen-free diet for baby and, if the baby is breastfed, the mother too.

“[If we suspect allergic colitis,] what we do is empirically remove what the most likely sources of the allergy are,” says Eitan Rubinstein, MD, a pediatric gastroenterologist at Boston Children’s Hospital. “In the majority of infants, the allergy is to milk, and sometimes to soy, but any protein can be the trigger.”

Most diagnoses of allergic colitis are made after the baby responds positively to the elimination of the suspected culprit, according the World Allergy Organization Journal review.

Treating Allergic Colitis in Infants

Treatment for allergic colitis is relatively straightforward and involves eliminating the offending proteins from your baby’s system.

If you’re feeding your infant with formula, you’ll need to switch to one that’s hypoallergenic.

If you’re breastfeeding, you’ll need to switch to a dairy-free diet. It takes up to 72 hours for a mother’s breast milk to become free of milk protein. During that time, you’ll need to give your baby a hypoallergenic formula.

According to Boston Children’s Hospital, roughly 30 percent of babies who are allergic to cow’s milk protein are also allergic to soy protein. If your baby’s symptoms don’t clear up, it is recommended that a nursing mother avoid soy as well as dairy.

Once you’ve altered your or the baby’s diet, you’ll usually see less bleeding within 72 to 96 hours. Sometimes, however, it can take longer for the colon to heal. Depending on the degree of irritation, it’s possible for rectal bleeding to continue for up to two weeks, says the report in World Allergy Organization Journal.

You’ll know when your infant is feeling better — his or her irritability will lessen, resistance to feeding will go away, and your baby will gain weight.

The condition also improves with passing time. At about 11 months, you can give your baby milk again to see if they have outgrown the allergy.

Dr. Rubinstein notes that more than 95 percent of allergic colitis cases disappear by the time an infant is one year old. If that doesn’t happen, you should continue to consult your doctor and perhaps a specialist, and repeatedly introduce milk every three months until your child begins to tolerate it.

“When you change everything and symptoms don’t go away and blood is still in the stool, further evaluation is needed,” says Rubinstein.

Your doctor might suggest a test called a flexible sigmoidoscopy to check the intestines for infection, polyps, or abnormal blood vessels close to the surface that could be causing bleeding. It’s also possible, though not usual, that a baby has a rectal fissure or tear.

During this time, it’s still important to introduce new foods into your child’s diet. Babies need to begin to get used to them. And solids, like cereals, contain new vitamins and minerals not found in breast milk or formula.

Tips for Managing Allergic Colitis in Infants

When your infant has allergic colitis, it’s important for you and the baby to adhere to the elimination diet and not reintroduce milk proteins too quickly. Here are some tips that may help you resolve your baby’s allergic colitis symptoms.

Always read foods labels. During the elimination period, it’s important to make sure what you’re buying for yourself to eat or feed to your baby doesn’t contain cow’s milk or soy milk. Don’t assume you know what the contents of a product are. Ingredients and additives change all the time.

Introduce new foods early in the day. It’s a good idea to introduce new foods into your baby’s diet first thing in the morning so that if an allergic reaction occurs you’ll know what caused it. For the same reason, new types of food shouldn’t be introduced more often than every three to five days.

Keep your pediatrician in the loop. When you change and add foods, involve your pediatrician. See your pediatrician when you need to, but no less than twice after allergic colitis is diagnosed. Your doctor will want to keep track of your baby’s weight and be sure your child is getting all the necessary nutrients.

Additional reporting by Jordan M. Davidson.

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Treatment of colitis in children

Home / Pediatrician / Treatment of colitis in children

Colitis is an inflammatory disease of the intestine, in which the epithelial layer of its mucous membrane gradually degenerates. The process of dystrophy is manifested in the thinning and weakening of the mucosa, as well as in the deterioration of its regenerative properties.

Causes of colitis

The development of the disease is affected by a combination of negative, both exogenous (external) and endogenous (internal) factors.

These include:

• congenital predisposition;
• fetal pathology;
• wrong power mode;
• poor quality diet;
• intestinal parasite infection;
• predisposition to allergies;
• intestinal infections;
• infection of the digestive tract with the bacterium Helicobacter pylori;
• uncontrolled intake of antibacterial and other drugs;
• intestinal dysbacteriosis.

Colitis in children under one year old most often develops against the background of congenital malformations of the gastrointestinal tract with the addition of frequent viral infections, a tendency to allergies and lactose intolerance. In the case of formula-fed babies, the risk factors also include the wrong choice of formula.

Symptoms of colitis

The younger the child, the more difficult it is to determine inflammation of the intestine. Often, the manifestations of the disease are taken by parents for a temporary problem. This is especially true for infants – in their case, the symptoms are blurred and may resemble a common indigestion due to a mild intestinal infection or a violation of the diet by a nursing mother.

In children older than one year, it is easier to identify the disease, because the symptoms become more pronounced and it is easier to determine what exactly worries him from the behavior of the child at this age.

Common symptoms for children of all ages include:

1. Intestinal disorders. Digestive disorders can manifest themselves in different ways and alternate with each other: from watery frequent stools to constipation lasting several days.
2. Increased flatulence. Due to the violation of the structure of the mucosa, intestinal immunity suffers, which causes an imbalance of microflora. It notes the predominance of pathogenic microorganisms, the result of whose vital activity is an increase in the volume of gases in the intestine. The child’s belly becomes swollen, the skin on it is stretched, belching appears, frequent gas discharge.
3. Nausea and vomiting occur at the stages when the child’s colitis is at the stage of development – this is how the body signals the onset of the pathological process in the gastrointestinal tract (GIT). Also, vomiting can be a companion of chronic colitis during periods of exacerbation.
4. Admixture in feces – pus, blood, bile, mucus. Sometimes the number of inclusions is so insignificant that it is possible to determine their presence only with the help of a laboratory analysis (coprogram).
5. Dehydration appears with frequent loose stools. In this case, along with feces, the body leaves a large amount of water. You can determine dehydration by dry, flaky skin, the smell of acetone from the mouth, pallor, lethargy.
6. Abdominal pain below the umbilicus.

Classification

According to the etiological factor, such a disease is divided into:

– primary – associated with congenital anomalies of the gastrointestinal tract or genetic predisposition;

– allergic colitis in children;

– alimentary, caused by food poisoning;

– medicinal; nonspecific colitis in children;

– toxic;

– parasitic, including pseudomembranous colitis;

– beam; post-infectious colitis in children;

– neurotic.

Depending on endoscopic and morphological changes, the inflammatory process can be:

– catarrhal;

– atrophic;

– ulcerative-erosive.

According to the clinical form of the course, there are the following types of inflammation:

– acute colitis in children;

– chronic colitis in children;

– nonspecific ulcerative colitis;

– spastic colitis in children.

Classification according to the nature of the course divides the inflammatory lesion of the large intestine into the following varieties:

– monotonous;

– recurrent;

– progressive;

– latent.

Depending on the severity, there are: mild colitis; moderate colitis; severe colitis.

In addition, there is a division of such a disease, which is dictated by the location of the inflammatory focus:

– typhlitis – corresponds to the lesion of the caecum;

– typhlocolitis – indicates the simultaneous involvement of the caecum and ascending colon in the pathology;

– transverse – indicates inflammation of the transverse colon;

– intestinal angulitis – is diagnosed when the inflammatory process affects the transverse colon and the descending part of the large intestine;

– sigmoiditis – caused by an inflammatory lesion of the sigmoid colon;

– proctosigmoiditis – characterized by inflammation of not only the sigmoid, but also the rectum;

– proctitis – speaks of inflammation of the rectum.

In addition, colitis in a child can be complicated and uncomplicated.

Diagnosis of colitis

Diagnosis is based on anamnesis, clinical picture, physical, laboratory, instrumental (X-ray, endoscopic) examination.

Blood tests in children with colitis reveal anemia, hypoalbuminemia, decreased electrolyte levels in the blood serum

Coprological examination reveals the presence of leukocytes, mucus, steatorrhea, amylorrhea, creatorrhea in the feces. Bacteriological examination of feces allows to exclude the infectious nature of acute and chronic colitis in children. An analysis of feces for dysbacteriosis, as a rule, demonstrates a change in the microbial landscape of the intestine due to an increase in opportunistic agents – staphylococci, proteus, candida.

Endoscopic examination of the intestine (colonoscopy, rectoscopy) in children often reveals a picture of catarrhal colitis: the mucous membrane of the large intestine is hyperemic, edematous; lymphoid follicles are enlarged; a large amount of mucus, petechial hemorrhages, vulnerability of the mucosa upon contact are found.

Treatment of colitis

Treatment of colitis in children up to three years of age and older is carried out to a large extent by normalizing the diet and diet. To alleviate the condition of the child and reduce the intensity of the manifestation of symptoms, a dairy-free diet enriched with meat, fish dishes, and eggs is prescribed. Artificial children up to a year are transferred to a lactose-free hypoallergenic milk formula.

In the case of breastfed children, the identification of the etiology of the disease is of great importance, since some cases of allergic colitis require an urgent transfer of the child to artificial nutrition or a strict diet of the nursing mother.

From the diet of older children during periods of exacerbation, it is necessary to exclude all products that impede the process of digestion, corrode the walls of the mucosa, and increase gas formation.

Medical treatment of colitis is based on oral medications that improve digestion and protect and restore the intestinal mucosa.

Your child’s health is in the safe hands of our doctors. Make an appointment with the pediatricians of the Medical Center “Sever” in Alexandrov by phone 8 (49244) 9-32-49.

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Allergic enteropathy.

What is Allergic Enteropathy?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Allergic enteropathy is an inflammatory disease of the small intestine of an allergic nature that occurs when antigens enter the body, causing an excessive, increased reaction of the immune system. Most often, the disease develops in young children. Allergic enteropathy is manifested by diarrhea, bloating, intestinal colic, regurgitation, insufficient weight gain. Diagnosis includes an examination by a pediatrician and an allergist-immunologist, laboratory tests and allergological tests, and an examination of the intestines. Treatment consists in stopping contact with the allergen, prescribing a hypoallergenic diet, and antihistamines.

ICD-10

K52.2 Allergic and alimentary gastroenteritis and colitis

• Causes
• Pathogenesis
• Symptoms of allergic enteropathy
• Diagnostics
• Treatment of allergic enteropathy
• Prognosis and prevention
• Prices for treatment

General

Allergic enteropathy (gastrointestinal form of food allergy) is a lesion of the mucous membrane of the small intestine when allergens enter the gastrointestinal tract. Most often, the disease occurs in young children and is associated with the appearance of hypersensitivity to the proteins of cow’s milk, soy and other products used in the introduction of complementary foods and the transition from breastfeeding to artificial.

The prevalence of food allergy among children under the age of 3 years is about 6-8%, in 10-15 years – 3-4%. At the same time, increased sensitivity to cow’s milk protein was found in 2-2. 5% of young children, to chicken protein – in 1-1.5%. As a rule, along with allergic enteropathy in children, there are signs of allergic lesions of other organs and systems (skin, respiratory tract, etc.).

Allergic enteropathy

Causes

More than 170 products are known that, upon penetration into the gastrointestinal tract, can cause the appearance of a gastrointestinal form of food allergy (allergic enteropathy), and their allergic activity is due to the presence of animal or vegetable proteins, glycoproteins, less often polypeptides.

In children under the age of one year, allergic enteropathy in most cases is due to increased sensitivity to cow’s milk protein, which contains more than ten antigens, of which αS1-casein and γ-casein have the highest activity. In school-age children and adults, the development of allergic reactions with intestinal damage is more common when eating egg protein, fish and seafood. The reaction of the immune system often occurs to dietary fiber of plant origin entering the body: wheat, rye, oatmeal, buckwheat and rice groats, soybeans, as well as some vegetables (carrots, celery, tomatoes) and fruits (bananas, citrus fruits).

In the development of food allergies in children and adults, the essential role of hereditary predisposition is undeniable. This is evidenced by the presence of allergic diseases in the patient’s relatives, as well as common manifestations of allergy in the patient with damage to the skin, bronchopulmonary system and the detection of hypersensitivity not only to food products, but also to plant pollen, house dust, medicines and other allergens.

Pathogenesis

In the occurrence of allergic enteropathy, a decrease in the barrier function of the gastrointestinal tract (due to enzymatic deficiency), a violation of the production of IgA also plays a role. Allergic reactions that develop when food antigens enter the gastrointestinal tract can be IgE-mediated, non-IgE-mediated, immunocomplex and cell-mediated. Non-IgE-mediated (in proctocolitis) and cell-mediated (in allergic enteropathy) reactions are characteristic of allergic bowel disease.

Symptoms of allergic enteropathy

Gastrointestinal allergy is manifested both by local signs of damage to the gastrointestinal tract (vomiting, intestinal colic, diarrhea) and by various extraintestinal manifestations of allergy (atopic dermatitis, eczema, bronchial asthma). The severity of the manifestation of certain clinical symptoms of the disease will differ depending on the age of the patient.

In young children, allergic bowel disease is manifested by cramping abdominal pain of the type of intestinal colic, regurgitation and vomiting, bloating, loose stools 5-6 times a day. Sometimes there may be intestinal bleeding with a change in the color of the feces. The general condition of the child is disturbed: there is anxiety, general weakness, pallor of the skin, sleep disturbance, appetite, malnutrition. Often, allergic enteropathy at this age is accompanied by skin manifestations of the type of atopic dermatitis (dry damaged skin, polymorphic rash).

Timely elimination of the allergen from the diet leads to the cessation of symptoms after 2-3 days. If the allergic lesion of the gastrointestinal tract is due to increased sensitivity to cow’s milk casein, the manifestations of enteropathy usually disappear by 2-3 years of age, even with regular consumption of dairy products.

In school-age children, adolescents and adults, the picture of the disease becomes more blurred and is characterized more often by dull pains in the navel, flatulence, unstable stools (constipation or diarrhea), loss of appetite, and nausea. Extraintestinal manifestations of allergy are rare. At the same time, allergens that cause allergic enteropathy at this age can sometimes be not only food products, but also medicines, plant pollen, household dust, etc.

Diagnostics

Clinical manifestations of allergic enteropathy are non-specific and occur in gastroenteritis and enterocolitis of various etiologies (including those caused by infectious agents of a viral and bacterial nature, helminths, protozoa, alimentary factors, chemical poisoning, inedible and poisonous products). To establish the correct diagnosis, it is necessary to carefully collect an allergic history, conduct a clinical examination of the patient (consultation of an allergist-immunologist, gastroenterologist), perform the necessary laboratory and instrumental studies.

An analysis of an allergic history reveals the presence of a hereditary burden (allergic diseases in relatives). As a rule, the sick child had previously observed or present at the time of the examination skin or respiratory symptoms of allergy. The appearance of clinical signs of allergic enteropathy (abdominal pain, vomiting, diarrhea) is associated with the ingestion of a food allergen (cow’s milk, eggs, fish, peanuts, etc.). The condition improves significantly after the elimination of the problematic food product from the diet.

In a laboratory study, a general blood test reveals eosinophilia (an increase in the number of eosinophils). Analysis of feces (coprogram) allows you to identify an increased content of red blood cells, eosinophils, neutrophils. Histological examination of biopsy specimens of the small intestine mucosa reveals signs of inflammation (edema and hemorrhage), infiltration of the lamina propria by lymphocytes, mast and plasma cells. In some cases, partial atrophy of the villi is detected. When conducting a specific allergological study, the content of total IgE, as well as specific IgE and IgG, is determined, skin allergy tests with a set of food allergens are used.

Differential diagnosis in allergic enteropathy is carried out, first of all, with celiac enteropathy, in which there are no extraintestinal manifestations of allergy, antigliadin IgA antibodies and antibodies to transglutaminase are detected.

Treatment of allergic enteropathy

Therapeutic measures include the elimination of the allergen and the appointment of a hypoallergenic diet, the use of antihistamines and anti-inflammatory drugs, enterosorbents, enzymes and membrane stabilizers, symptomatic treatment of individual manifestations of the disease.

If breastfeeding is carried out, a strict hypoallergenic diet for the mother is necessary, with the exception of potential food allergens and individually intolerant foods. Formula-fed children are prescribed special therapeutic mixtures with whey and casein protein hydrolysates, as well as mixtures based on goat’s milk. The timing of the introduction of complementary foods for children with allergic enteropathy is postponed to 5-6 months of life, while hypoallergenic cereals (buckwheat, rice, corn), single-component vegetable purees, meat (veal, horse meat, pork, rabbit, turkey) are used. Cow’s milk, cottage cheese, fish and eggs are completely abandoned in the first year of life, peanuts are excluded up to three years. Older children and adults follow an individually tailored hypoallergenic diet for at least six months.

Of the antihistamines in the first year of life, the use of dimethindene (in drops), chloropyramine (in tablets), cetirizine (in drops), and also ketotifen is recommended. From the year you can use loratadine, and from the age of six – fexofenadine hydrochloride and ebastine. Enterosorbents are usually applied within one to two weeks during the period of exacerbation. According to the indications, enzymes (pancreatin), preparations containing bifidobacteria and lactobacilli, symptomatic agents (antifoaming agents, antiemetics) are prescribed.

Prognosis and prevention

The transition to an elimination diet leads to a regression of the symptoms of enteropathy. Serious health effects usually do not develop. Prevention of allergic enteropathy consists in following a hypoallergenic diet for a pregnant and nursing mother, breastfeeding up to 4-6 months of life, introducing complementary foods to a child not earlier than the fourth month of life, and eliminating potential allergens from the diet at an older age and in adults.

You can share your medical history, what helped you in the treatment of allergic enteropathy.

You can get advice from an immunologist and a dermatologist in Volgograd, Volzhsky and Mikhailovka at the DIALINE clinics. We offer a wide range of services, including laboratory tests and examinations on advanced equipment. To make an appointment with a specialist, simply call or leave a request on the website.

Sources

1. Food allergy in children: practical aspects of insufficient effectiveness of diet therapy/ Filatova T.A.// Pediatrics. – 2011 – T.90 (#6).
2. Diagnosis and treatment of enteropathy / Parfenov AI / / Russian medical journal. – 2013 – No. 13.
3. Endogenous peptides in the diagnosis of allergic enteropathy in children/ Shumatova T.A., Zernova E.S., Katenkova E.Yu., Shishatskaya S.N.// Modern problems of science and education. – 2015 – No. 5.
4. This article was prepared based on the site: https://www.krasotaimedicina.ru/

IMPORTANT
Information from this section cannot be used for self-diagnosis and self-treatment.