From the Guidelines
Allergic colitis is a condition that occurs primarily in infants when they develop an allergic reaction to proteins in food, most commonly cow's milk protein, and treatment involves eliminating the offending allergen from the diet. The condition occurs because certain food proteins trigger an immune response in the intestinal mucosa, leading to inflammation, increased intestinal permeability, and symptoms including blood-streaked stools, diarrhea, vomiting, irritability, and poor weight gain 1.
Key Considerations
- For breastfed infants, mothers should eliminate dairy products from their diet for at least 2-4 weeks to see if symptoms improve.
- For formula-fed infants, switching to an extensively hydrolyzed formula (such as Nutramigen or Alimentum) or an amino acid-based formula (such as Neocate or EleCare) is recommended.
- Symptoms typically resolve within 72-96 hours after eliminating the allergen, though complete healing of the intestinal mucosa may take 2-4 weeks.
- Most infants outgrow this condition by 12 months of age, at which point reintroduction of dairy can be attempted gradually under medical supervision.
Management and Prevention
- It's essential to maintain adequate nutrition during elimination diets, particularly ensuring sufficient calcium intake.
- Early identification and dietary management are crucial to prevent nutritional deficiencies and promote normal growth and development.
- The provided evidence does not directly address allergic colitis, but the general principles of managing inflammatory bowel disease and other conditions can be applied to inform treatment decisions 1.
Diagnosis and Differential Diagnosis
- The diagnosis of allergic colitis is based on clinical presentation and response to dietary changes.
- Other conditions, such as infectious colitis or inflammatory bowel disease, should be considered in the differential diagnosis.
- Histological examination may be helpful in distinguishing between different types of colitis, but it is not a primary diagnostic tool for allergic colitis 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition and Symptoms of Allergic Colitis
- Allergic colitis is not directly mentioned in the provided studies, but ulcerative colitis (UC) and microscopic colitis (MC) are discussed as inflammatory diseases of the colon.
- UC typically manifests as diarrhea, abdominal pain, and bloody stool 2.
- MC is characterized by chronic, watery, non-bloody diarrhea and normal endoscopic and radiologic findings 3, 4.
Treatment Approaches for Inflammatory Colitis
- Mesalamine is a 5-aminosalicylic acid compound used as first-line therapy to induce and maintain clinical remission in patients with mild-to-moderate UC 2.
- Budesonide is recommended for induction of clinical remission in patients with moderate-severe microscopic colitis 3.
- Corticosteroids are the mainstay of treatment for hospitalized patients with acute severe ulcerative colitis (ASUC), but the addition of mesalamine may not provide significant benefits 5.
Management and Complications of Inflammatory Colitis
- The goals of management for UC are to induce and maintain clinical remission and to screen for complications such as colorectal cancer and extraintestinal manifestations 2.
- Surgery may be necessary for UC patients who develop acute attacks of severe colitis or those who do not respond to medical therapy 6.
- Microscopic colitis has a variable disease course, and some patients may experience occasional, intermittent symptoms, while others may have more chronic and progressive symptoms 3.