Food protein-induced allergic proctocolitis: long-term dietary behaviors and course of allergic diseases

Nutritional difficulties and growth impairment are notable concerns in childhood food allergies. This study aimed to evaluate whether long-term follow-up of infants diagnosed with food protein-induced allergic proctocolitis (FPIAP) revealed disruptions in feeding behaviors and how their growth and development compared to healthy individuals.

Patients diagnosed with FPIAP in the paediatric allergy outpatient clinic were identified. After a mean of 50.72 months (17.00-85.50 months) from the initial diagnosis, the patients were recalled and growth-development evaluations were performed. In addition to demographic information, the progression of the patients' allergic diseases and treatment processes were reviewed. Anthropometric measurements and physical examinations were performed. The Child Eating Behaviour Questionnaire (CEBQ) was completed according to parental responses.

Male children constituted 52.94% of the FPIAP group and 44.12% of the control group (p = 0.425). Height and weight percentiles were similar between the groups (p = 0.225; p = 0.253). Emotional overeating (p = 0.043), emotional undereating (p = 0.002), food enjoyment (p < 0.001), and desire to drink (p<0.001) were significantly higher in the FPIAP group compared to controls. Additionally, rumination behaviors were more prominent in the FPIAP group (p = 0.038). The prevalence of recurrent wheezing was also significantly higher in the FPIAP group (p = 0.039).

Our findings suggest that children with FPIAP are at greater risk for feeding difficulties and recurrent respiratory infections, such as bronchitis, later in life. Beyond elimination diet recommendations, managing factors affecting nutritional adequacy should be prioritized in the treatment of food-allergic infants. Well-managed treatment processes can reduce allergic comorbidities and slow growth development.