Food Allergy & Anaphylaxis
Food Protein-Induced Enterocolitis Syndrome
FPIES is a severe non-IgE mediated gastrointestinal food allergy hallmarked by delayed onset (2-4 hours); profuse, protracted vomiting that often results in dehydration and lethargy; and, in some cases, bloody, profuse diarrhea. The reaction is triggered by non-antibody immune-cells that recognize particular food proteins. This reaction occurs only in the gut.
The resulting damage causes the gut to become “leaky” and lose water as well as bleed in some individuals. The reaction is not treatable by epinephrine since it does not involve mast cells. Rather, aggressive intravenous fluids are required for rapid rehydration. Often children require observation in the emergency room.
Triggers are similar to classic food allergy, including milk and soy, but also include other foods such as rice, oat, meats, poultry, and vegetables (both solid food and liquid food triggers). FPIES presents in very young children – often in the first few months of life or upon weaning from breast feeding – and in general is outgrown between ages 3 and 5. There are no diagnostic tests for FPIES (e.g., no skin testing for food triggers).
For more information about FPIES, visit the International Association for Food Protein Enterocolitis Web site.