Imagine that you are feeding your precious infant, and within a few hours of eating, he starts vomiting repetitively, becomes floppy and lethargic, and you need to go to the emergency department. Now imagine that this happens over and over. Each time your baby undergoes extensive testing for serious conditions like sepsis and intestinal obstruction, you are told the tests are normal, yet you know there is nothing normal about what your baby is experiencing. You follow up with your pediatrician and still have no answers about what is happening. How do you go about introducing new foods, and are you brave enough to try?
As an allergist, the above story is very familiar. While on paper this diagnosis may seem clear, in practice it often is not. Patients often have multiple episodes before the diagnosis is considered. This causes significant stress for families and often leads to many unnecessary diagnostic tests. It is important that we as a medical community raise awareness of food protein-induced enterocolitis syndrome (FPIES) to provide families timely diagnoses and guidance to reduce stress and improve care.