About Allergies


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). Unlike a food allergy it is a non-IgE-mediated reaction of the immune system.

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 gray or blue, dehydration, and even going into shock. Immediate medical care is necessary, and 9-1-1 should be called if a child is experiencing these or other serious symptoms. In cases of shock, sometimes epinephrine is used.

Other emergency FPIES treatments include steroid treatments and IV rehydration. Children may also have growth issues as a result of untreated FPIES, which must be addressed and monitored by health care providers.

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). New awareness about FPIES among care 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. In some cases, a feeding tube is required. Most children outgrow FPIES by school age, and regular visits to a treating physician are part of the treatment plan. A dietician can help to ensure that nutritional needs are met.

FPIES can be a very difficult and sometimes frightening experience, especially when a diagnosis is first being made. There are support networks for parents dealing with FPIES. Talk to your health care provider to find local associations, and see the resources to the left for more information.