Formula Selection Influencing Tolerance Of Cow’s Milk Food Protein–Induced Allergic Proctocolitis

Objective: To evaluate the effect of different Formula Selection on the tolerance and long-term prognosis in children with cow’s milk food protein–induced allergic proctocolitis(FPIAP).Methods: Analyzed by retrospective cohort study,between January 1,2015 to December 31,2016,85 children with cow’s milk FPIAP who were diagnosed and followed up effectively by the Department of Gastroenterology,Children’s Hospital of Chongqing Medical University were included and divided into 6 groups based upon the formula used:breast milk group(n=18);extensively hydrolyzed formula group(n=22);amino acid-based formula group(n=17);breast milk + extensively hydrolyzed formula group(n=17);breast milk + amino acid-based formula group(N=7);extensively hydrolyzed formula + amino acid-based formula group(n=4).Compare the difference on the immune tolerance and prognosis in cow’s milk FPIAP children with different Formula Selection.Influential factors for the immune tolerance,the subsequent other allergic food and follow-up other allergic disease during the 5-year period were determined by logistic regression analyses.Results: The baseline main demographic and clinical characteristics in 5 groups had no significant difference(P < 0.05).There was no significant difference in the duration of tolerance acquiring,the rate of children acquiring oral tolerance in 1 year,1.5 year,2 year,2.5 year,3 year,3.5 year,4 year,4.5 year and 5 year among the 6 groups(P < 0.05).Investigators did not find a statistically significant difference in the prognosis in Cow’s Milk FPIAP with different formula choice based on the incidence of other allergic foods and allergic diseases in the follow-up(P <0.05).Binary logistics regression analysis coefficient revealed that the incidence of other allergic foods was influenced by 2 factors:The positive family history of an allergic diathesis(OR=6.497,95%CI:1.539～27.434,P=0.011),and bloody stool symptom(OR=4.685,95%CI:1.006 ～ 21.829,P=0.049).the incidence of other allergic diseases was influenced by bloody stool symptom(OR=0.107,95%CI:0.024～0.468,P=0.003).Conclusion: The prognosis of Cow’s Milk FPIAP is generally good.Different formula selections have no significant impact on the long-term tolerance and prognosis.Children with a family history and obvious bloody stool symptom are more likely to have a higher risk of subsequent allergic foods.Children without typical clinical digestive manifestations,such as bloody stools,may be more likely to have allergic diseases affecting other systems in the follow-up.