LACK OF RESPONSE OF ALLERGIC COLITIS TO PROTEIN HYDROLYSATE FORMULA (PHF)

Abstract

28 Allergic (eosinophilic) colitis is a common cause of bloody stools in infants. 30-50% of infants with cow's milk protein sensitivity exhibit sensitivity to soy milk protein. These infants are routinely thought to be effectively treated by the use of a PHF. However, in our clinical experience many of our patients appear to have persistent rectal bleeding on a PHF. A retrospective study was performed on all infants who presented to our Division from 1/97-4/99 with persistent rectal bleeding on a PHF who underwent flexible sigmoidoscopy. There were a total of 42 infants (17 F, 25 M). Mean age of onset of rectal bleeding was 4.5 weeks (range 3 days-20 weeks) with 33.3% <2 weeks, 69.0% <4 weeks and 92.9% <8 weeks. At the onset of symptoms 28.7% were already receiving PHF, 33.3% were fed cow's milk formula, 35.7% soy formula and 2.3% breastmilk. At the time of the procedure all patients had been on a PHF for a minimum of 2 weeks. Pathology revealed the presence of increased numbers of eosinophils in 100% with eosinophilic cryptitis in 66.7% of infants. In conclusion, many infants with allergic (eosinophilic) colitis have persistent rectal bleeding despite prolonged use of a PHF.