Dietary protein enterocolitis

Adverse food reactions are commonly reported in the first several years of life, but many are poorly documented. in a prospective study of nearly 500 newborns through the first 3 years of life, however, Beck documented that 8% of the children had a reproducible response to oral food challenge, approximately 60% with diarrhea, 40% with emesis, and 20% with irritability and colicky discomfort.(6) The majority of these reactions are to cow milk protein, with more than 80% clinically resolving by 3 years of age, and most are not IgE-mediated.(16) The IgE-mediated syndromes of oral allergy, gastrointestinal anaphylaxis, and some children with eosinophilic esophagogastritis are not discussed in this article. Primarily, the non-IgE syndromes are usually defined on the basis of their clinical presentations as enteropathy (if primarily it is a malabsorption disease), enterocolitis (if emesis, diarrhea, and bleeding are prominent in an infant who is clinically ill), or proctitis (if there is mild rectal bleeding in an infant who is clinically well).(24) The clinical distinctions are further summarized in Table 1.