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Food Hypersensitivity (Non–IgE-Mediated, Gastrointestinal), Pediatric

Kirsten M. Kloepfer, MD, MS Reviewed 10/2018
 


BASICS

DESCRIPTION

  • A non–IgE-mediated reaction to a food protein that involves the gastrointestinal (GI) tract

  • Previously referred to as milk protein intolerance

  • Includes the following:

    • Food protein–induc...

DIAGNOSIS

HISTORY

  • Proctocolitis

    • Occurs between 1 and 6 months of age (usually between 2 and 8 weeks)

    • Specks or streaks of blood (± mucus) in the stool of an otherwise healthy infant

    • Absence of vomiting an...

TREATMENT

GENERAL MEASURES

  • Proctocolitis

    • Exclusively breastfed infant: Continue breastfeeding with mom eliminating all forms of dairy including casein and whey in packaged food.

    • Symptoms should improve w...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Proctocolitis

    • 95% tolerate reintroduction of food(s) at 9 months of age. Patient can reintroduce offending food at home 4 to 6 months after beginning protein elimi...

ADDITIONAL READING

  • Boyce JA, Assa’ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Allergy...

CODES

ICD9

  • 558.3 Allergic gastroenteritis and colitis

  • 579.8 Other specified intestinal malabsorption

  • 271.3 Intestinal disaccharidase deficiencies and disaccharide malabsorption

ICD10

  • Z91.011 Allergy to mil...

FAQ

  • Q: Will my child outgrow this?

  • A: For proctocolitis, most children outgrow milk and/or soy intolerance by 12 months of age. For enterocolitis, symptoms resolve within 1 to 2 years. For FPIES, sympt...

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