Food Protein-Induced Enterocolitis Syndrome (FPIES) is a non-IgE-mediated food allergy, which predominantly affects infants but can also impact adults. Unlike other food allergies, FPIES symptoms include delayed vomiting, lethargy, and diarrhoea, often requiring emergency medical attention. Recent studies shed light on evolving trends in FPIES diagnosis, food triggers, and management.
Figure 1: Proposed diagnostic criteria for infantile and adult food protein-induced enterocolitis.
Guidelines and Recent Findings- The first international guidelines for FPIES were published in 2017. These guidelines have contributed to increased awareness and proper diagnosis, but new studies suggest a need for updates. Research indicates FPIES affects both paediatric and adult populations, with some patients developing symptoms in adulthood, a phenomenon not previously recognized.
Recent studies have also expanded the list of FPIES food triggers, now including solid foods such as grains and shellfish. A particularly significant finding is the growing number of patients with atypical FPIES, which involves both IgE sensitization and FPIES symptoms. These developments have important implications for updating FPIES guidelines to address diverse patient populations and evolving diagnostic needs.
As awareness of FPIES grows, there is an increasing need to tailor guidelines to adult patients and expand food challenge protocols. Future guidelines will need to reflect these emerging patterns in food triggers, diagnostics, and management strategies. The field will continue to evolve as more research highlights new facets of FPIES diagnosis and care.
Journal Article: Anvari, Sara, et al. “Current and Future Perspectives on the Consensus Guideline for Food Protein-Induced Enterocolitis Syndrome (FPIES).” Allergology International.
Summary by Faith Oluwamakinde
