Food Protein Induced Entercolitis Syndrome and Food Induced Allergic Proctocolitis of Infancy

Children who are struggling with a food allergy can thrive with the right diagnosis and care plan. If your child has a non-IgE mediated food allergy, like Food Protein Induced Entercolitis Syndrome (FPIES) or Food Induced Allergic Proctocolitis of Infancy (FPIAP), the Center for Allergic and Immune Disorders has the expertise to help. Our multidisciplinary team includes allergists, immunologists, psychologists, dieticians, gastroenterologists, and geneticists, all working with you to navigate these conditions so your child can get back to enjoying their usual daily life.

What are FPIES and FPIAP?

Food Protein-Induced Enterocolitis Syndrome (FPIES) is a type of non-IgE mediated food allergy. It is triggered by a particular food and causes severe vomiting, diarrhea, and dehydration. In some cases, symptoms can progress to shock brought on by low blood pressure, poor blood circulation, and electrolyte problems.

FPIES is different from a typical food allergy. Although most food allergy reactions happen soon after contact with an allergen, FPIES reactions can be delayed by hours. This leads to frequent misdiagnosis because symptoms are similar to a stomach bug.

Although any food can be an FPIES trigger, the most common culprits include milk, soy, and grains like oats, rice, and barley. Most children with FPIES have only one or two food triggers, but it is possible to have FPIES reactions to several foods. FPIES often develops in infancy, usually when a baby is introduced to solid food or formula.

Another delayed, non-IgE mediated reaction is Food Protein Induced Allergic Proctocolitis (FPIAP). In this condition, the distal colon (descending part of the colon) becomes inflamed in response to one or more food proteins. Milk and soy are the most common triggers, which has led to FPIAP being mistakenly called a “milk protein allergy.” FPIAP is often seen in breastfed infants because small amounts of the trigger food can travel through breast milk. However, it can also affect infants receiving cow’s milk or soy-based formulas. Symptoms may begin at one to four weeks of age and include blood in bowel movements.

Services We Provide

FPIES and FPIAP can be tough conditions to diagnose, so it’s important to see a specialist with experience in these areas. There are no blood or skin tests for FPIES or FPIAP, so the diagnosis is made based on symptoms and medical history.

Treatment involves removing suspected trigger foods from the infant’s diet, as well as the mother’s diet while she is breastfeeding.

At the Center for Allergic and Immune Disorders, we have specialized experience identifying culprit food(s), teaching families how to avoid them while maintaining nutrition, and preparing for accidental exposures. 

In most cases, these conditions eventually go away on their own. Most children outgrow FPIES by age three or four, while FPIAP usually resolves by eight to twelve months.   

Meet Our Team

Our specialized team works closely with our patients and their families to provide the best possible care.