Abstract
Food protein-induced proctocolitis should be considered as the disease of otherwise healthy infants with blood-streaked stools. Although the diagnostic gold standard is a dietary elimination-challenge test, the diagnosis is often made empirically in infants showing improvements in response to elimination of causative food antigens after exclusion of anal fissures and infectious colitis. However, such empiric diagnosis may often result in overdiagnosis that leads to unnecessary elimination of diets and usage of hypoallergic formula. Recently, pathological diagnostic criteria of food protein-induced proctocolitis employing endoscopic examination have been introduced and widely accepted. We have experienced an otherwise healthy breast-fed 3-month male with bloody mucus stools. Although the infant did not respond to the inappropriate restriction of mother's intake of milk and other considered-to-be causative foods, the mother hesitated to stop breastfeeding. The endoscopic examination of rectum revealed that the infant had eosinophillic proctocolitis, which convinced the mother to stop breastfeeding. The symptoms of the infant were improved with an amino acid-based formula after stopping breastfeeding. In this case, the endoscopic examination was a safe and useful method to make a diagnosis.
