Small amount of rectal bleeding in otherwise healthy infants, attributed to food protein allergy. Onset in early neonatal period (newborn to 6 months) and characterized by blood-streaked stool. More than 50% of affected infants are breast-fed, with the remainder of patients feeding on cow's milk or soy protein. Other signs and symptoms include mucus in stools, mild anemia, peripheral blood eosinophilia, focal colitis, and lymphoid nodular hyperplasia. Food protein-induced proctocolitis is not to be confused with the more severe food protein-induced enterocolitis syndrome (FPIES), which is characterized by severe bloody stools, diarrhea, and vomiting in an ill-appearing infant.
Management involves eliminating offending food protein antigens from diet of infant and breast-feeding mother. The diagnosis is clinical; skin prick testing and RAST testing are not recommended and should be negative. The symptoms usually resolve within a week or two.