Food protein-induced enterocolitis syndrome

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated food allergy that primarily affects infants and young children. It is characterized by delayed gastrointestinal symptoms, such as vomiting, diarrhea, and dehydration, typically occurring a few hours after ingesting the trigger food. In severe cases, FPIES can lead to life-threatening complications, such as hypovolemic shock.

Symptoms

The symptoms of FPIES can vary in severity and may include:

• Persistent vomiting
• Diarrhea, often with blood or mucus
• Lethargy or irritability
• Poor weight gain or failure to thrive
• Dehydration
• Low blood pressure
• Pale or bluish skin color

Trigger Foods

FPIES can be triggered by a wide range of foods, but some common culprits include:

• Cow's milk
• Soy
• Rice
• Oats
• Barley
• Wheat
• Eggs
• Chicken
• Fish
• Shellfish

Diagnosis

Diagnosing FPIES can be challenging, as the symptoms can be similar to other gastrointestinal disorders. A thorough medical history, including a detailed account of the symptoms and food exposures, is crucial. In some cases, an oral food challenge may be necessary to confirm the diagnosis.

Management

The primary treatment for FPIES is strict avoidance of the trigger foods. This often requires careful reading of food labels and avoiding cross-contamination. In severe cases, an emergency action plan may be necessary to address potential reactions.

Prognosis

Most children with FPIES outgrow the condition by the age of three to five years. However, the specific timing can vary depending on the individual and the trigger food. Regular follow-up with a healthcare provider is essential to monitor the child's progress and ensure appropriate dietary modifications.

Resources

For more information on FPIES, you can visit the following resources:

• The International Association for Food Protein Enterocolitis (IAFFPE)
• Food Allergy - National Institute of Allergy and Infectious Diseases (NIAID)
• Food Protein-Induced Enterocolitis Syndrome (FPIES) - American Academy of Pediatrics (AAP)