![]() ⚠️Simple Food Protein Induced Enterocolitis Syndrome (𝐅𝐏𝐈𝐄𝐒) or Food Protein Induced Proctocolitis (𝐅𝐏𝐈𝐏) is often mistaken for a viral infection causing vomiting and diarrhoea, with occasional blood in stool. ‼️Often, and not wrongly, it may be diagnosed as a 𝘯𝘰𝘯-𝘐𝘨𝘌 𝘢𝘭𝘭𝘦𝘳𝘨𝘺, with the most common being CMPA. ✅This is because it normally tends to have mild symptoms. ⁉️Important to note that severe 𝐅𝐏𝐈𝐄𝐒 is relatively rare and less common than Anaphylaxis! ✴𝐅𝐏𝐈𝐄𝐒 most common triggers: ▶️Milk ▶️Soy ▶️Rice# ▶️But can be associated with a long list of food proteins 🧒👧Most children will be able to tolerate the food causing the reaction by the age of 2 or 3 years old. In some cases, it may persist throughout life. ❗Children with recurrent episodes may suffer from poor growth and weight loss - failure to thrive. ✅Usually children will recover very fast from an episode of 𝐅𝐏𝐈𝐄𝐒, as long as appropriate diagnosis and treatment is made. 🔴For severe cases, the best treatment is fluid resuscitation. ⚠️What does not work to treat them: ➡️Adrenaline auto-injector ➡️Antihistamines ➡️Steroids ➡️Antibiotics Though you will often see all of them being used due to the worry it is either Anaphylaxis or Sepsis. ✴In the case of 𝐅𝐏𝐈𝐏, most symptoms tend to resolve by 6 months of age (50%) or 9 months of age (95%). ✳The advice is to reintroduce the causing food into the mother's diet after an exclusion period of 6 months or give it to the child when reaching 12 months of age. ⚠️For both cases, if the child is formula fed be aware that: 1️⃣Medical and dietetic advice needs to be sought before a restriction diet is done 2️⃣It might take 2 weeks for improvement to be seen 3️⃣The child will need and Extensively Hydrolysed Formula (EHF - first choice) or eventually an Amino Acid Formula (AAF - second choice) ❗In the case of a breastfeeding mother, a restriction diet needs to be guided by a dietitian. ✅This is to be sure appropriate nutrition (focusing on protein and calcium) is achieved. ‼️For 𝐅𝐏𝐈𝐄𝐒, there seems to be a 30% chance of people involved to develop either 𝘢𝘵𝘰𝘱𝘪𝘤 𝘥𝘦𝘳𝘮𝘢𝘵𝘪𝘵𝘪𝘴 (eczema), 𝘢𝘴𝘵𝘩𝘮𝘢 or 𝘩𝘢𝘺𝘧𝘦𝘷𝘦𝘳 (allergic rhinitis). www.facebook.com/permalink.php?story_fbid=247380117092229&id=109164090913833
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AuthorDr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health. Archives
February 2021
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