Troncone Riccardo, Discepolo Valentina
Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University of Naples "Federico II," Naples, Italy.
J Pediatr Gastroenterol Nutr. 2009 Apr;48 Suppl 2:S89-91. doi: 10.1097/MPG.0b013e3181a15d1a.
The colon is a site of allergic reaction to food proteins. The most common manifestation is allergic proctocolitis. Although frequent in infancy, it may also affect older children. The diagnosis of allergic proctocolitis is mainly based on clinical and histological grounds, but there is a risk of overdiagnosis; challenge is strongly recommended to avoid unnecessary and expensive formula or changes in maternal diet that may discourage continuation of breast-feeding. The benign clinical course and the spontaneous resolution in most infants suggest the need for further prospective studies to validate markers that allow the identification of those children needing a dietary approach. It remains to be assessed whether lymphoid nodular hyperplasia of the colon is a manifestation of food allergy. Finally, allergic proctitis may present clinically with refractory constipation; the true prevalence of food allergy-related constipation remains to be assessed.
结肠是对食物蛋白发生过敏反应的部位。最常见的表现是过敏性直肠结肠炎。虽然在婴儿期很常见，但也可能影响大龄儿童。过敏性直肠结肠炎的诊断主要基于临床和组织学依据，但存在过度诊断的风险；强烈建议进行激发试验，以避免不必要且昂贵的配方奶粉更换或母亲饮食改变，而这些可能不利于母乳喂养的持续进行。大多数婴儿的良性临床病程和自发缓解表明，需要进一步开展前瞻性研究，以验证能够识别那些需要采取饮食疗法的儿童的标志物。结肠淋巴样结节增生是否为食物过敏的一种表现仍有待评估。最后，过敏性直肠炎在临床上可能表现为难治性便秘；与食物过敏相关的便秘的真实患病率仍有待评估。
