Rectal bleeding and lymphonodular hyperplasia in children can be caused by food hypersensitivity.
Dr Antonio Carroccio and colleagues from Italy verified whether similar clinical and endoscopy presentations in adults can be due to food hypersensitivity.
The team enrolled 64 consecutive adult patients with rectal bleeding.
All underwent routine assays, colonoscopy, and histology study.
|An oligoantigenic diet resolved the rectal bleeding in 9 patients|
|Clinical Gastroenterology & Hepatology|
The researchers found that 15% of patients showed lymphonodular hyperplasia as the unique sign at colonoscopy.
An oligoantigenic diet resolved the rectal bleeding in 9 patients, and the reintroduction of several foods caused symptom reappearance.
Double-blind placebo-controlled challenges with cow's milk and wheat protein confirmed the food hypersensitivity; symptoms reappeared 1 to 96 hours after the challenge.
None of the patients were positive for IgE-mediated assays.
In patients with lymphonodular hyperplasia and food hypersensitivity, histology of the ileum and colon mucosa showed a higher number of lymphoid follicles.
In addition, these patients showed a higher number of intraepithelial and lamina propria eosinophils compared with the other patients with rectal bleeding.
Dr Carroccio’s team concluded, “Recurrent rectal bleeding can be caused by food hypersensitivity in adult patients.”
“Endoscopic evidence of lymphonodular hyperplasia characterizes these cases.”