What Is FPIES?

Food protein-induced entercolitis syndrome (FPIES) is a rare food allergy. FPIES can affect people of all ages, but it most commonly affects children and infants.

Unlike typical food allergies, FPIES only affects the gastrointestinal (GI) tract. It can cause severe vomiting, diarrhea, and stomach cramping. These symptoms typically show up within two hours of eating the food that triggers the allergy.

Who Does FPIES Affect?

FPIES most commonly affects infants and young children. Adults can still have an FPIES allergy or even develop one later in life.

Understanding FPIES in Babies: A Guide for Parents

FPIES is very rare. It’s so rare that researchers haven’t been able to estimate the number of Americans with the allergy. FPIES is difficult to diagnose, and it’s possible many people will never receive a correct diagnosis. Children may grow out of their allergy before a diagnosis is made.

If you or your loved one has a family history of allergic disease like asthma, hay fever, or eczema, you’re 40 to 80 percent more likely to be diagnosed with FPIES.

What Are FPIES Triggers?

Food triggers for FPIES can be different from person-to-person. Any food can be a trigger, but some triggers are more common.

The most common FPIES triggers include:

  • soy and cow’s milk foods, including infant formula
  • grains, including oats, rice, and barley
  • proteins, including chicken, fish, and turkey

Although it’s a food allergy, FPIES isn’t diagnosable with a typical skin prick or blood test. These two tests are usually used to diagnose a food allergy. They detect reactions to a variety of triggers, including foods. Because an FPIES reaction is contained to your GI tract and doesn’t involve antibodies, these two tests will not work. You must consume or eat the food in order to trigger symptoms.

For that reason, your doctor may conduct an oral challenge. To do this, you will consume a small amount of the possible trigger under your doctor’s supervision. You’ll be monitored for the signs and symptoms of an FPIES reaction. If you have a reaction, this may be the confirmation your doctor needs for an FPIES diagnosis.

What Are the Symptoms of FPIES?

The first symptoms of FPIES often show up at a very early age. Children and infants may begin showing the symptoms of FPIES when they first begin taking formula or breast milk, or eating solid foods. Any time a new food is introduced, an infant can experience an allergy to it. In adults who develop FPIES, the symptoms may begin at any point in life.

The symptoms of FPIES include:

  • vomiting that often starts two hours after eating the trigger food
  • diarrhea following vomiting
  • stomach cramps
  • changes in blood pressure
  • changes in temperature
  • diarrhea
  • weight loss
  • lethargy and lack of energy
  • dehydration

In extreme cases, individual with FPIES reactions may have to be hospitalized for treatment. Rehydration with intravenous (IV) fluids may be necessary if the allergic episode is severe.

For children, FPIES symptoms can ultimately lead to failure to thrive, a condition that can stunt their overall growth and development. That’s why proper diagnosis and management are vital.

The symptoms of FPIES are easily confused with stomach viruses, food poisoning, and other viral or bacterial infections. That’s what makes diagnosing FPIES so difficult. If you notice these symptoms are chronic or occur after you or your child eats certain foods, convey your suspicions to your doctor. Begin the conversation about food allergies and you may find the answers you need.

How Is FPIES Treated?

FPIES has no treatment or cure. The best practice is strict avoidance of the trigger foods.

If your infant is allergic to milk or formula, your doctor will work with you to find an allergy-friendly formula or one designed for sensitive stomachs. If the trigger is just one or a few foods, avoiding those foods will prevent an allergic episode. If the number of triggers is high, you may need to work with your doctor and dietitian to create a diet that is healthy, nutritious, and also safe for your allergy.

Milk Protein Allergy: What Are My Formula Options?

What Is the Prognosis for FPIES?

The outlook for life with FPIES differs based on your age at diagnosis. Children often outgrow their food allergy by age 3 or 4. If an FPIES allergy lasts into older childhood or even adulthood, the likelihood that you’ll outgrow the allergy is smaller. Adults who develop the allergy later in life rarely outgrow it.

When to See a Doctor

If you suspect that you or your child has FPIES, talk with your doctor. To confirm a diagnosis, your doctor may refer you to an allergist, a doctor that specializes in the diagnosis and treatment of allergies. FPIES is hard to identify, but a diagnosis can help you and your family find the answers you need. Ultimately, that’s the best way to cope with and handle life with this condition. Don’t give up the search for an answer. Partner yourself with a doctor who won’t give up either.