Proposal for management of the infant with suspected food protein-induced allergic proctocolitis

we hypothesized a different management of child\r\nwith suspected FPIAP, easier regarding the diet to follow.\r\nThe management pathway illustrated in Figure 1 is different depending\r\non whether duration of hematochezia is less than/equal to\r\n1 month or higher. We chose 1 month as cutoff because this is the\r\nsum of the maximum duration (21 days) of hematochezia during follow-\r\nup\r\nin children randomly assigned to continue their normal diet\r\nand the mean duration (10 days) of bloody stools before admission in\r\nthe study of Arvola et al4\r\nThe most important points of our proposal are two:\r\n• In case of hematochezia with duration less than or equal 1 month,\r\nwe suggest waiting for the spontaneous resolution without elimination\r\ndiet;\r\n• In cases of a duration of more than 1 month, we suggest an elimination\r\ndiet and, if hematochezia disappears, we suggest a challenge.