Food Protein-Induced Proctocolitis Syndrome

This chapter discusses the background, diagnosis, treatment, and prognosis for the food protein-induced proctocolitis (FPIP) syndrome. FPIP or proctitis is a benign and transient non-IgE-mediated food allergy, characterized by an inflammatory response limited to the rectum and distal sigmoid colon induced by ingested food proteins. From a clinical point of view, the typical presentation is blood-streaked stools appearing in the first few weeks of life in otherwise healthy breastfed infants or infants receiving infantile formulas (i.e. milk or soy formulas). No specific diagnostic test is available and the diagnosis is based mainly on the clinical response to a strict elimination diet and exclusion of other etiologies. FPIP is characterized by an eosinophil-dominated inflammation limited to the rectum and distal sigmoid colon. Amino acid-based formula is rarely needed to control patients with FPIP.