Food Protein Induced Enterocolitis Syndrome (FPIES)

Reviewed by Bruce J. Lanser, MD

FPIES is an uncommon adverse GI reaction to a particular food. It is different from more common food allergies like IgE mediated food allergy. The exact mechanism is not clearly understood. Patients typically experience symptoms before 1 year of age, and it often can be difficult for providers to diagnose until a few episodes have occurred. The reactions almost always include profuse vomiting, a few hours after eating a trigger food. The child can also be lethargic, have cool or clammy skin, and look very sick.

FPIES affects less than 0.5% of the population. Reactions to new foods are uncommon after the first year of life. FPIES can be outgrown within a few years, but certain foods may persist longer. The treatment for FPIES involves strict avoidance of the trigger food, and often a special dietary plan for introducing new foods. Your child’s allergist will typically work closely with a nutritionist to help make this plan, and monitor growth and nutrition. Sometimes it may be necessary to also work with a feeding therapist.

 

Most Common FPIES Foods

  • Milk
  • Soy
  • Oat
  • Rice

 

Other Common FPIES Foods

  • Legumes (peas, beans, lentils)
  • Poultry (chicken and turkey)
  • Egg
  • Fish and Shellfish
  • Banana
  • Sweet Potato (*not white potato)
  • Wheat


 

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