Food Protein-Induced Enterocolitis Syndrome (FPIES)
FPIES (pronounced “F-Pies”) stands for Food Protein-Induced Enterocolitis Syndrome. It is a type of food allergy that involves inflammation (“-itis”) of both the small (“entero-”) and large intestines (“-col-”). In other words, it is a gastrointestinal immune reaction that occurs after the ingestion of certain foods (e.g. milk, eggs, rice, and shellfish). FPIES typically occurs in the first few weeks or months of life when children begin ingesting solid foods but can also occur into adulthood as well. Characteristically, severe and repetitive vomiting will occur around 2-3 hours after the ingestion of the trigger food. Accompanying symptoms can range from mild, involving increases in reflux and runny stools, to life-threatening, where affected individuals can go into shock due to a severe dehydration.
Similar to other food allergies, it is best for individuals with suspected or confirmed FPIES to avoid the offending triggers. However, FPIES is NOT the same as typical immediate food allergies, which are often associated with symptoms like hives and respiratory distress. As such, the administration of epinephrine (e.g. EpiPen ®) will not help with an FPIES reaction. Instead, oral rehydration (i.e. drinking water with small amounts of salt and sugar) and anti-nausea medication (e.g. Zofran ®) can help with individuals experiencing an FPIES reaction.