Abstract
Eosinophilic colitis is a well recognized clinical entity mainly associated with food allergies. Empiric treatment options include dietary allergen exclusion (extensively hydrolyzed protein formula and elimination diet), anti-allergy medications (antihistamines and leukotriene receptor antagonists) and corticosteroids. We evaluated the effectiveness of dietary antigen exclusion on clinical remission of eosinophilic colitis in infants and young children. We retrospectively reviewed charts of all infants and children ≤3 years of age who were diagnosed with eosinophilic colitis (defined as mucosal eosinophilia ≥20 hpf−1) from 1 January 2011 to 31 December 2013 at a tertiary children’s hospital in China. Forty-nine children were identified with eosinophilic colitis. Elemental formula, simple elimination diet or combination therapy resulted in clinical improvement in 75%, 88.2% and 80% of patients, respectively. In conclusion, eosinophilic colitis in infants and children ≤3 years of age responded well to dietary allergen exclusion.
Highlights
Eosinophilic gastrointestinal disorders (EGIDs) are a spectrum of chronic diseases characterized by a range of symptoms and eosinophilic infiltration of the gastrointestinal tract and have been increasingly reported in recent years [1,2,3]
The aim of this study is to evaluate the effectiveness of dietary antigen exclusion on clinical remission of eosinophilic colitis in Chinese infants and young children ≤ 3 years of age
Our results showed that eosinophilic colitis defined as colonic mucosal eosinophilia ≥20 hpf−1 was common in infants and children ≤3 years of age undergoing colonoscopy
Summary
Eosinophilic gastrointestinal disorders (EGIDs) are a spectrum of chronic diseases characterized by a range of symptoms and eosinophilic infiltration of the gastrointestinal tract and have been increasingly reported in recent years [1,2,3]. Dietary exclusion of allergenic foods is the key component of a treatment regimen [8,9,10,11]. Among the entities of EGIDs, eosinophilic esophagitis has been well-studied and elemental diet has been shown to be effective in inducing histological remission in more than 90% of children [12,13]. The efficacy of elemental diet or dietary elimination in infants and children with eosinophilic colitis has been rarely reported. We hypothesize that elemental diet or dietary exclusion of allergenic foods is an effective treatment in infants and young children with eosinophilic colitis. The aim of this study is to evaluate the effectiveness of dietary antigen exclusion on clinical remission of eosinophilic colitis in Chinese infants and young children ≤ 3 years of age
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