Managing and Treatment of Adult FPIES
The first step in FPIES management is avoidance of your trigger foods. The good news is the majority of individuals react to one or two foods.1, 2
If you have an accidental exposure, fluid rehydration and potentially the administration of ondansetron is key. If you are able to tolerate fluids by mouth, small sips of fluids every few minutes can be beneficial. If you cannot, then intravenous fluids will be needed. Ondansetron, if prescribed by your doctor could be considered. This medicine has been shown to be helpful in studies of children with FPIES.3-5 In children, this medicine has been helpful, however some individuals will still need emergency care. Contraindications to ondansetron include some types of heart disease and medications that may interact.
If you are on medicines to control your blood sugar, blood pressure or blood volume and you are having difficulty staying hydrated, you should reach out to your doctor.
If it has been a while since you have had a reaction or your reactions are not consistent and repetitive, it can be worth discussing your symptoms with your physician.
1. Gonzalez-Delgado P, Muriel J, Jimenez T, Cameo JI, Palazon-Bru A, Fernandez J. Food Protein-Induced Enterocolitis Syndrome in Adulthood: Clinical Characteristics, Prognosis, and Risk Factors. J Allergy Clin Immunol Pract. 2022.
2. Crespo J, Perez-Pallise ME, Skrabski F, et al. The Natural Course of Adult-Onset Food Protein-Induced Enterocolitis Syndrome. J Allergy Clin Immunol Pract. 2022.
3. Miceli Sopo, S., Bersani, G., Monaco, S., Cerchiara, G., Lee, E., Campbell, D., & Mehr, S. (2017). Ondansetron in acute food protein‐induced enterocolitis syndrome, a retrospective case–control study. Allergy (Copenhagen), 72(4), 545–551. https://doi.org/10.1111/all.13033
4. Le, S., Boissieu, D., Garcelon, N., Lageix, F., Bodilis, H., Branellec, A., Karila, C., Faour, H., Delacourt, C., & Lezmi, G. (2020). Efficacy of oral ondansetron in acute FPIES: A case series of 6 patients. Allergy (Copenhagen), 75(11), 2949–2951. https://doi.org/10.1111/all.14335
5. Leonard, S. A., Miceli Sopo, S., Baker, M. G., Fiocchi, A., Wood, R. A., & Nowak-Węgrzyn, A. (2021). Management of acute food protein-induced enterocolitis syndrome emergencies at home and in a medical facility. Annals of Allergy, Asthma, & Immunology, 126(5), 482–488.e1. https://doi.org/10.1016/j.anai.2021.01.020