Rare DiseasesFood Protein-Induced Enterocolitis Syndrome (FPIES): Causes, Symptoms, Diagnosis, Treatment, and Management

Food Protein-Induced Enterocolitis Syndrome (FPIES): Causes, Symptoms, Diagnosis, Treatment, and Management

Food Protein-Induced Enterocolitis Syndrome (FPIES) is a type of food intolerance where a child experiences gastrointestinal symptoms in response to certain foods. It commonly occurs with foods like milk and soy protein, but can also occur with other foods. FPIES symptoms typically occur between 2 and 6 hours after consuming the food and usually resolve rapidly when the food is removed from the body. Diagnosis is made when symptoms recur and are associated with a specific food. Food provocation tests and sometimes stool samples are used to confirm the diagnosis. FPIES management involves eliminating the trigger food from the diet. Under the supervision of a doctor, alternative foods may be recommended to ensure the child’s continued growth and development on a healthy diet. FPIES cases and management are individualized and specific to each family, so guidance from a healthcare professional is important.

What Are the Causes of Food Protein-Induced Enterocolitis Syndrome?

The exact cause of food protein-induced enterocolitis syndrome is not fully understood. However, it is believed that certain factors may contribute to this condition:

Genetic Predisposition: Family history can increase the risk of FPIES.

Immune System: The immune system may play a role in the development of FPIES.

Early Food Intolerance: The intestinal system in babies develops the ability to react to certain foods after birth.

Breast Milk or Formula: Babies can react to certain foods while being fed with breast milk or formula.

What Are the Symptoms of Food Protein-Induced Enterocolitis Syndrome?

The symptoms of food protein-induced enterocolitis syndrome typically begin within 2 to 6 hours after consuming specific foods and may include:

  • vomiting
  • diarrhea
  • feeding difficulties
  • weakness and restlessness
  • dehydration

How Is Food Protein-Induced Enterocolitis Syndrome Diagnosed?

The diagnosis of food protein-induced enterocolitis syndrome is made by carefully observing the symptoms and identifying the food trigger:

Patient History and Symptom Evaluation: The doctor evaluates the child’s symptoms, when the symptoms started, and how long they lasted.

Keeping a Food Diary: Families can keep a food diary to determine which foods the child ate and when the symptoms occurred.

Laboratory Tests: There is no specific laboratory test for diagnosing FPIES. However, stool samples and blood tests may sometimes be used.

Oral Food Challenge: The most definitive test for FPIES diagnosis is the controlled reintroduction of the trigger food under the supervision of a doctor.

How Is Food Protein-Induced Enterocolitis Syndrome Treated?

The treatment of food protein-induced enterocolitis syndrome involves eliminating the trigger food from the diet and managing the symptoms:

Eliminating the Trigger Food from the Diet: When a specific food protein causing FPIES symptoms is identified, that food should be immediately and completely removed from the child’s diet.

Healthcare Professional Supervision: The treatment of a child diagnosed with FPIES should be done under the supervision of a pediatrician or allergist.

Managing the Symptoms: Medications or treatment methods may be necessary to alleviate symptoms and provide relief for the child.

Selecting Alternative Foods: When the trigger food is eliminated, alternative and nutritious foods may need to be added to the child’s diet.

Preventing Contact with the Trigger Food: The family of a child diagnosed with FPIES should prevent the child from coming into contact with the trigger food.

Risks and Emergency Action Plan: Families should know what to do if their child’s symptoms worsen.

How Should Food Protein-Induced Enterocolitis Syndrome Be Managed?

The management of food protein-induced enterocolitis syndrome should be carefully planned to control the child’s symptoms, support healthy growth and development, and prevent contact with the trigger food:

Eliminating the Trigger Food from the Diet: When a specific food protein causing FPIES symptoms is identified, that food should be immediately and completely eliminated from the child’s diet.

Selecting Alternative Foods: When the trigger food is eliminated, the child’s diet should be supplemented with healthy and balanced alternatives.

Monitoring Growth and Development: The growth and development of a child diagnosed with FPIES should be closely monitored.

Reading Labels Carefully: Families should read labels carefully when shopping and selecting packaged foods.

Being Mindful in Restaurants and Social Settings: It is important to ensure that the child does not consume trigger foods during restaurant visits and social events.

Emergency Action Plan: Families should know what to do if their child’s symptoms worsen.

Family Education: Families should be aware of FPIES and its management.

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