Allergic colitis is an inflammatory condition affecting the lining of the colon, primarily observed in infants. This condition develops when an infant’s immune system reacts to specific food proteins present in their diet. It is a non-IgE mediated immune response, meaning it does not involve the immediate, severe allergic reactions often associated with typical allergies. While the condition can be concerning for parents, it is generally mild and usually resolves as the infant matures.
Causes and Symptoms of Allergic Colitis
Allergic colitis results from an immune system reaction to proteins in certain foods. The most common trigger is cow’s milk protein, whether consumed directly through formula or transferred via breast milk from the mother’s diet. Soy protein is another frequent cause, and less commonly, proteins from eggs, wheat, or corn can also be involved.
The most recognizable sign of allergic colitis is small specks or streaks of bright red blood and/or mucus in the infant’s stool. Infants often appear otherwise healthy and continue to thrive despite these findings. Other symptoms include increased fussiness, particularly during or after feeding, excessive gas, and loose or frequent bowel movements. Poor weight gain can also occur.
The Diagnostic Process
Diagnosing allergic colitis involves a careful review of the infant’s health history and a physical examination. The doctor will inquire about the infant’s feeding method, stool frequency and appearance, and any other symptoms. A stool sample may be tested for occult (hidden) blood using a stool guaiac test.
A key diagnostic approach involves an elimination diet. If the infant is breastfed, the mother removes suspected allergens, starting with dairy and potentially soy, from her diet for several weeks. For formula-fed infants, the doctor recommends switching to a specialized hypoallergenic formula. The healthcare provider observes for symptom improvement, which often occurs within 72 to 96 hours of the dietary change. Invasive procedures like a colonoscopy are rarely necessary, reserved for atypical cases or when symptoms do not improve with dietary changes.
Management and Treatment Strategies
Management of allergic colitis centers on removing the offending food protein from the infant’s diet. These dietary adjustments should always be implemented under the guidance of a pediatrician or allergist to ensure the infant receives adequate nutrition. The specific approach depends on whether the infant is breastfed or formula-fed.
For breastfed infants, the primary treatment involves the mother adopting an elimination diet. She will need to strictly avoid foods containing the identified allergen, most commonly cow’s milk protein. This requires careful label reading, as dairy ingredients can be hidden in many processed foods. If symptoms persist, soy and other common allergens like eggs or wheat might also need to be removed from the mother’s diet.
For formula-fed infants, treatment involves switching to a specialized formula where proteins are broken down, making them less likely to trigger an immune response. This often means using an extensively hydrolyzed formula. If symptoms do not improve with an extensively hydrolyzed formula, an amino acid-based formula, which contains proteins in their simplest form, may be recommended. These dietary changes aim to eliminate the inflammatory trigger and allow the colon to heal.
Long-Term Outlook for Allergic Colitis
The long-term outlook for infants diagnosed with allergic colitis is good. This condition is usually outgrown as the child’s digestive and immune systems mature. Most infants no longer experience symptoms by their first birthday, with many resolving completely by three years of age.
Once symptoms have resolved for a sustained period, the problem food can be reintroduced into the child’s diet. This reintroduction should always occur under the supervision of a healthcare professional. Gradual reintroduction helps confirm the child has outgrown the sensitivity and allows for monitoring of any returning symptoms. This approach ensures the child’s continued well-being.