What is FPIES?

FPIES is a severe delayed food allergy of the gut, it is understood to be a T-cell mediated response, a Non-IgE Food Allergy in which food is considered a foreign invader and the body fights, or attacks it, until it can violently expel it; although the exact mechanisms are still not well understood.

Symptoms include: profound vomiting (often to bile), diarrhea and/or constipation. These symptoms can quickly lead to: lethargy, low body temperature, low blood pressure and in severe cases, sepsis-like shock. And still yet, many parents report children also experiencing many discomforting symptoms while the body fights this reaction and these can include: extreme stomach pains, excessive gas, runny stools with or without mucus/blood, acid reflux, rashes/eczema, sleep disturbance, and agitation/inconsolable crying.

FPIES is a clinical diagnosis (based on symptoms and history) there is currently no test for it.

This is my definition of FPIES, defined by my own research in: medical journal articles, other families living through FPIES I 'meet' on the support groups and, of course, my own son. You can learn more about my research in FPIES here on this blog, and at The FPIES Foundation website.

Tuesday, March 15, 2011

IgE Allergy vs. Non-IgE Allergy


IgE FOOD ALLERGY:
(Typical food allergy)
Immediate onset reactions
Non- IgE Food Allergy: (PROTEIN INTOLERANCE)

Delayed onset reactions
The body's abnormal immune response to a food, usually a protein.
Mediated by non-IgE antibodies and/or cellular immune responses.
Common Conditions*:
1.     IgE food allergy (ie egg, milk, peanut, tree nut, soy, wheat, shell fish…)
2.     Eosinophilic Disorders
3.     Oral Allergy Syndrome







*list is not inclusive, please see your doctor for any symptoms/diagnosis
Common conditions*:
1.     Milk/Soy Protein Intolerance
2.     Multiple Food Protein Intolerance
3.     Food protein-Induced Allergic Protocolitis
4.     Food Protein Induced Enterocolitis Syndrome
5.     Food Protein Enteropathy
6.     Celiac Disease (also auto-immune)
7.     Eosinophilic Disorders (also IgE)


*list is not inclusive, please see your doctor for any symptoms/diagnosis
Common Respiratory Symptoms:
·          Sneezing, runny nose, congestion, hay fever
·          Shortness of breath
·          Throat swelling
·          Cough
·          Allergic asthma
·          Pink eye/eye swelling
Common Respiratory Symptoms:
·          Non-allergic sneezing, congestion, runny nose
·          Non-atopic cough, asthma
·          Recurrent or chronic sinus inflammation/infections
·          Reflux disease
·          Recurrent ear infections
·          Eye swelling
·          Enlarged adenoids
COMMON GI SYMPTOMS:
  • Nausea/Vomiting/Diarrhea
  • Cramping abdominal pain
  • Reflux/Difficulty swallowing
  • Swelling (tongue,lips,face)
  • Itching/swelling of the tongue, lips, mouth
  • Dizziness
  • Fainting
Severe reactions (anaphylaxis) can be life threatening and require immediate medical attention and can include:
  • Itching or tightness in the throat
  • Difficulty breathing
  • Wheezing/coughing
  • Rapid heart rate
  • Low blood pressure
  • Loss of consciousness
Symptoms usually occur within minutes to 1-2 hours after ingesting the food.

COMMON GI SYMPTOMS for MSPI/MFPI:
  • Mucus/Blood in Stools
  • Inconsolable and Extended Crying/Colic
  • Disrupted Sleep
  • Malabsorption/Vitamin Deficiency
  • "Spit-up" an hour+ after feeding
  • Sulfur/sour smelling stools
  • Diarrhea and/or constipation
  • Red ring around the anus
  • Peeling diaper rash
  • Gas/wind
  • Mouth itching
  • Dysbiosis
Symptoms can occur hours to days after ingesting the food.

COMMON SYMPTOMS for FPIES will include above and:
  • Loss of appetite
  • Violent/forceful/projectile vomiting
  • Lethargy
  • Dehydration
  • Low body temp or fever
  • Low blood pressure
  • Shock
Click here for more information on:
Common skin symptoms:
·          Eczema
·          Hives
·          Rashes (dermatitis)
Common skin symptoms:
·          Eczema
·          Rashes/flushing
·          Itchy skin
·          Diaper rash.
Diagnostic Tests:
·          RAST (serum IgE)
·          Skin Prick Testing
·          EE requires endoscopy

Diagnostic Tests:
·          Atopy Patch Testing
·          Food elimination and challenge
·          Endoscopy/colonoscopy
·          Medical history

References:

Non-IgE food Allergy by Dr.Jyonouchi http://www.pcrcd.org/Jyonouchi_IA-DT.pdf 
2010 Guidelines for Diagnosis and Management of Food Allergy in the United States  http://www.niaid.nih.gov/topics/foodallergy/clinical/Pages/default.aspx

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