Cow s milk and soy protein are most often responsible. Symptoms include protracted vomiting and diarrhea. Specific descriptions of the histological findings are not available, because the diagnosis can be made clinically. Some small-bowel specimens show mild villous injury with inflammatory infiltration, while colonic specimens reveal crypt abscesses and a diffuse inflammatory infiltrate. Cow s milk proteins and soy proteins can cause an uncommon syndrome of chronic diarrhea, weight loss, and failure to thrive, similar to that appearing in celiac disease.
Vomiting is present in up to two thirds of patients.
Small bowel biopsy shows an enteropathy of variable degrees with villous hypotrophy. Total mucosal atrophy, histologically indistinguishable from celiac disease, is a frequent finding. Intestinal protein and blood losses can aggravate the hypoalbuminemia and anemia that are frequently observed in this syndrome. The nonceliac food-induced enteropathy has been less frequent and less severe in the last 25 years. Cases more recently described tend to present with patchy intestinal lesions.