What is FPE?
FPE is a type of non-IgE-mediated food allergy. Non-IgE-mediated food allergy is often referred to as gastrointestinal (gut) food allergy. For this reason, it is sometimes confused with food intolerance. Reactions happen because of an abnormal immune response to food proteins and are generally delayed (1 to 72 hours after eating or drinking the food).
A non-IgE-mediated food allergy cannot be diagnosed with a skin prick test or IgE antibody blood test. A diagnosis can only be made after an elimination diet.
FPE occurs because of inflammation in the small intestine caused by allergy.
FPE occurs in babies soon after food is introduced.
Signs of FPE
- Diarrhoea
- Abdominal pain
- Vomiting
- Poor weight gain and growth
Babies are often unsettled and irritable and sleep poorly. Growth and development can also be affected.
What foods cause FPE?
The most common food triggers are cow’s milk, soy, egg and wheat.
Less common triggers are peanut and tree nuts.
Diagnosis of FPE
Skin tests and blood tests are not helpful to diagnose babies with FPE.
Medical causes of blood in the stools should first be excluded by the doctor.
The suspected trigger food/s should be removed and when symptoms have settled, put back into the diet to confirm the diagnosis.
Management of FPE
FPE is managed by the removal of the food trigger as advised by your treating doctor.
A paediatric allergy dietitian can help with a nutrition assessment and advice.
Long-term outcomes with FPE
It is recommended to reintroduce the food trigger to the mother’s or baby’s diet six months after it was removed or at 12 months of age. For babies with severe symptoms, such as blood-stained diarrhoea, the trigger foods should be introduced under the supervision of the treating doctor or a paediatric allergy dietitian.
Useful links
ASCIA has further information on Food Protein-Induced Allergic Proctocolitis (FPIAP)
ASCIA has a Management Plan for Delayed Allergic Reactions to foods, including FPIAP and FPE