Food protein-induced enterocolitis syndrome (FPIES)

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Food protein-induced enterocolitis syndrome is oftentimes called as delayed food allergy. This is a serious illness that causes episodes of nausea and vomiting as well as diarrhea. In some circumstances, the symptoms can progress to dehydration due to the continuous vomiting and diarrhea as well as shock that is triggered by the low blood pressure and poor circulation of blood.

Just like with other types of food allergy, the allergic reactions caused by FPIES are instigated by the ingestion of a food allergen. Even though any food can be considered as a trigger, the common culprits include soy, milk and grains. Many children with FPIES have only 1-2 food triggers but it is also possible to experience reactions to several foods. It is important to note that FPIES often develops in infancy usually when the baby is introduced to formula or solid food.

Difference of FPIES to food allergy

Most cases of food allergy reactions occur within minutes or shortly after coming in contact with a food allergen. As for FPIES allergic reactions, they are delayed usually occurring within hours after eating the potential allergen. In most allergies, the immune system overreacts to the allergen by releasing IgE antibodies. It is important to note that these antibodies are responsible for triggering the release of chemicals that instigate the symptoms of an allergic response.

Just like with other types of food allergy, the allergic reactions caused by FPIES are instigated by the ingestion of a food allergen.

How FPIES is diagnosed

The symptoms of FPIES overlap with other health conditions, thus a diagnosis is not always evident. Since there is no laboratory testing or skin tests to check if an individual has delayed food allergy, the diagnosis of the condition is based on the history, symptoms and physical examination. The allergist will take a detailed history including foods eaten and the timeline of the reactions experienced by the individual.


The ideal way to properly manage FPIES is to strictly avoid the food that instigates an allergic response. This would require careful attention to the diet of the child. In case a severe reaction occurs, the treatment involves the administration of IV fluids to stabilize the fluid loss from diarrhea and vomiting. In addition, steroids are also given to help ease the symptoms of a reaction.

Luckily, FPIES typically resolves over time. The child should be closely monitored by a doctor so that his/her condition is under check. The doctor will discuss the foods that are safe to include in his/her diet and when it may be time to determine if the condition has resolved. As long as proper medical care and a personalized diet plan for proper nutrition is followed, children with FPIES can grow and thrive normally.

Once you suspect that a child experiences a delayed allergic reaction, it might be food protein-induced enterocolitis syndrome (FPIES). A doctor should be consulted for proper assessment of the condition and start the suitable treatment plan.

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