05 May What is FPIES?
Food Protein Induced Enterocolitis Syndrome
What is FPIES?
FPIES is a type of food allergy that is non-IgE mediated. It is most often triggered by cows milk and soy but can be related to other foods such as: rice, oats, barley, green beans, peas, sweet potato, squash, chicken, and turkey. It often shows up in the first weeks of life or at an older age for the exclusively breast fed child.
As each child with FPIES is different, reactions can vary in severity and duration and can be unpredictable with each episode. Typically, there is a delayed response (often 2-3 hours) before the onset of severe and repetitive vomiting, diarrhea, low blood pressure, and eventual dehydration. Symptoms are often misinterpreted as a ‘stomach bug’ leading to a delayed diagnosis. In more serious cases, reactions can be severe leading to shock.
An allergist and or a gastrointestinal doctor should be involved in making an FPIES diagnosis. The most definitive test is a medically supervised oral food challenge whereby a suspect food is given to the child in a controlled environment. As FPIES is not IgE-mediated, patch testing is not effective in diagnosis.
Treatment will vary with each case. For example, an infant who is reacting to dairy may be put on a hypoallergenic or elemental formula. Another child may be told to avoid the offending food for an extended period of time. In other cases, a child may be advised to introduce new foods into their diets at a very slow pace (ie. One new food every 3 weeks).
Typically, FPIES is outgrown by 3 years of age but, once again, this is an average with each individual varying in presentation, treatment, and eventual maturation from the allergy.