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WILLIAM J. WENNER, JR, MD
Department of Pediatrics The Milton S. Hershey Medical Center The Pennsylvania State University College of Medicine Hershey, PA 17033

Am J Dis Child. 1990;144(1):15-16.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Sir.—In the March 1989 issue of AJDC Berezin et al¹ stated that "colonoscopy is the most effective means of establishing a definitive diagnosis" of milk intolerance of infancy. They implied a diagnosis protocol for hematochezia consisting of colonoscopy with multiple biopsy procedures, treatment with protein hydrolysate formula, and repeated colonoscopy in 2 weeks. They cautioned that "histologic findings may be similar in other disease states [but] rapid resolution and reappearance of colonic abnormalities after withdrawal and rechallenge... clearly establish a clinical diagnosis of protein intolerance." This would require four colonoscopies and at least two biopsies.

The cost of a colonoscopsy is about $500, and a biopsy with pathologic diagnosis adds up to $700. Using the protocol implied by Berezin et al, this would cost the patient between $1200 and $4800. This cost does not include office visits to a specialist, laboratory evaluations, or incidental costs due to time . . . [Full Text PDF of this Article]

Footnotes
Reprint requests to Division of Allergy and Immunology, Department of Pediatrics, Washington University School of Medicine, 400 S Kingshighway Blvd, St Louis, MO 63110 (Dr Polmar).

We thank Drs Paul Quie and James Keating for critical review and kind encouragement.

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