Non-specific inflammatory bowel disease or allergic colitis in small children - what is the final diagnosis

The reason of bleeding from alimentary tract in small children - may sometimes be a big problem and we may need a long observation before making the diagnosis. One of the most frequent reasons of bleeding is food allergy, which resembles allergic colitis. However, bleeding can be the first symptom of ulcerative colitis or Crohn's disease, but it is very rare in small children. We present three cases of small children with bleeding from alimentary tract, in which it was difficult to make the final diagnosis. In our cases, the endoscopic and histopathological examination showed changes, which suggested non-specific inflammatory bowel disease. The microabscesses in crypts and inflammatory infiltration in the mucosa indicated ulcerative colitis. Moreover, one child had also inflammatory infiltration in the oesophagus and duodenum, which is typical for Crohn's disease. We conclude that even when the clinical course suggests that the reason of presenting symptoms was food allergy, there is need for longer observation until one can make the final diagnosis.