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Allergic Proctocolitis Is a Risk Factor for Functional Gastrointestinal Disorders in Children

Giovanni Di Nardo1, Cesare Cremon2, Simone Frediani3

  • 1Pediatric Gastroenterology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy; Pediatric Gastroenterology Unit, International Hospital Salvator Mundi, Rome, Italy.

The Journal of Pediatrics
|January 21, 2018
PubMed

Insights

Infants with allergic proctocolitis may develop functional gastrointestinal disorders (FGIDs) later in childhood. This early-life condition is a new risk factor for persistent digestive symptoms in children.

Area of Science:

  • Pediatric Gastroenterology
  • Allergy and Immunology
  • Childhood Health Outcomes

Background:

  • Allergic proctocolitis is a condition causing self-limiting rectal bleeding in infants.
  • Functional gastrointestinal disorders (FGIDs) are common in childhood and can have long-term impacts.
  • The potential link between early-life allergic conditions and later FGIDs is not well-established.

Purpose of the Study:

  • To investigate if allergic proctocolitis in infancy predisposes children to developing FGIDs later in childhood.
  • To identify risk factors associated with FGIDs in children with a history of allergic proctocolitis.

Main Methods:

  • A cohort study involving 80 infants diagnosed with allergic proctocolitis and 80 matched controls.
  • Longitudinal follow-up via telephone interviews every 12 months until age 4.
  • Assessment of FGIDs using the Questionnaire on Pediatric Gastrointestinal Symptoms, Rome III version.

Main Results:

  • 15.0% of children with allergic proctocolitis developed FGIDs, compared to 5.0% of controls (P=0.035).
  • Children with allergic proctocolitis had an adjusted odds ratio of 4.39 for developing FGIDs.
  • Duration of hematochezia was the only significant independent predictor for FGIDs development (OR, 3.14).

Conclusions:

  • Allergic proctocolitis is identified as a novel risk factor for FGIDs in children.
  • Early-life allergic inflammation may trigger persistent digestive symptoms, supporting the concept of 'postinflammatory' FGIDs.
  • This finding broadens the understanding of FGID etiology beyond infectious triggers.
Abstract

Keywords:
allergic proctocolitischildrenfunctional gastrointestinal disorders

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