Food Protein-Induced Enterocolitis Syndrome (FPIES)

Food Protein-Induced Enterocolitis Syndrome (FPIES) is an inflammation involving both the small intestine and the large intestine (colon).

Symptoms include severe vomiting and diarrhea and usually occur 2-3 hours after eating a food. FPIES symptoms can be very serious and can include turning grey or blue, dehydration, and very rarely going into shock. Call 9-1-1 if a child is experiencing these or other serious symptoms, as immediate medical care is necessary. In cases of shock, epinephrine is sometimes used.

Other emergency FPIES treatments include steroid treatments and IV rehydration.

FPIES can be difficult to diagnose because symptoms of vomiting and diarrhea may at first look like stomach flu. In fact, it is not uncommon for families to go through several visits to the ER and their GP before a referral and a diagnosis are made (usually by an allergist or gastroenterologist). Children may develop growth issues as a result of untreated FPIES, so it’s important to address any concerns with your healthcare provider.

New awareness about FPIES among healthcare providers is now leading to quicker diagnosis in many regions of Canada. Since skin testing and other traditional methods will not identify FPIES, sometimes an in-office food challenge is done to determine FPIES.

Any food can cause an FPIES reaction, but the most common triggers are dairy and soy. Treatment involves identifying and avoiding the food that causes the reaction. Most children outgrow FPIES by school age, and regular visits to a treating physician are part of the treatment plan. A dietitian can help ensure the child is well-nourished.

FPIES can be challenging to manage, especially when a diagnosis is first made. There are support networks for parents dealing with FPIES. Talk to your healthcare provider to find local associations, and see the resources below for more information.

Watch our webinar

With this webinar, you’ll learn the basics of FPIES, including diagnosis, common food triggers, symptoms, dietary management and treatment.

This webinar features Dr. Anna Nowak-Wegrzyn, MD, PhD, a pediatric allergist and immunologist, professor of Pediatrics at the NYU Grossman School of Medicine, and Director of the Pediatric Allergy Program at Hassenfeld Children’s Hospital at NYU Langone.