Allergic colitis physical examination

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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

Patients with allergic colitis may appear well in the case of FPIAP or may appear lethargic when they have FPIES. Physical examination of patients with FPIES is usually remarkable for signs of dehydration, pallor and poor weight.

Physical Examination

Type of Allergic colitis Physical Examination
Food protein-induced allergic proctocolitis[1][2][3][4]
  • Child is usually well-appearing
  • The weight and height of the child is appropriate for age
  • Mild pallor may be noticed
  • Child may be restless when having abdominal pain
  • Stool contain streak of blood with or without mucus
Food protein-induced enterocolitis syndrome[4] Acute
  • The child is dehydrated within a few hours after exposure to the offending protein
  • The child is lethargic when severe
  • May be in shock
  • Pallor is observed, especially with frank bloody diarrhea
  • The child may appear dusky
  • Abdominal distention may be seen
  • May develop edema
Chronic

Symptoms occur with a background chronic exposure

  • The child's weight and height are low for the age
  • May develop edema
  • May have abdominal distension
  • Signs of dehydration will also be observed following acute exposure

References

  1. Hwang JB, Hong J (2013). "Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?". Korean J Pediatr. 56 (12): 514–8. doi:10.3345/kjp.2013.56.12.514. PMC 3885785. PMID 24416045.
  2. 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.
  3. 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.
  4. 4.0 4.1 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.

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