Food Protein-Induced Enterocolitis Syndrome (FPIES): Review of Recent Guidelines

  • Sheeba Cherian
  • Pooja Varshney
Food Allergy (T Green, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Food Allergy


Purpose of Review

To increase understanding of food protein-induced enterocolitis syndrome (FPIES), a non-immunoglobulin E (IgE)-mediated reaction to food, by reviewing a growing body of literature, including recently published international consensus guidelines.

Recent Findings

FPIES primarily affects infants and young children and is characterized by the delayed onset of gastrointestinal symptoms, predominantly repetitive vomiting, in response to a trigger food. Symptoms are often severe and can lead to shock. Diagnosis can be challenging due to a wide differential diagnoses and lack of disease biomarkers. FPIES is a clinical diagnosis, with allergy testing playing a very limited role, if any. Medically supervised oral food challenges are used to monitor resolution of disease, which generally occurs in early childhood.


FPIES is an important condition presenting to clinicians in a variety of settings. Recent international consensus guidelines and a growing body of literature can better equip practitioners to care for these often-challenging patients.


FPIES Food protein-induced enterocolitis syndrome Food allergy Non-IgE-mediated food allergy 


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PediatricsDell Medical School at The University of Texas at AustinAustinUSA
  2. 2.Dell Children’s Medical Center of Central Texas/Dell Children’s Medical GroupAustinUSA

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