Food Induced Enterocolitis Syndrome Blood Test

What is Food Induced Enterocolitis Syndrome (FPIES)?

Food Induced Enterocolitis Syndrome (FPIES) is a severe non-IgE mediated food allergy causing delayed gastrointestinal reactions including vomiting, diarrhea, and dehydration in infants and young children. It is caused by an abnormal immune response to specific food proteins, most commonly milk, soy, rice, oats, and gelatin. The Allergen Specific IgE Gelatin Porcine test is the most important blood test for identifying gelatin as a potential FPIES trigger food.

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What causes Food Induced Enterocolitis Syndrome (FPIES)?

FPIES is caused by an abnormal immune system response to specific food proteins that triggers severe inflammation in the small intestine and colon. The most common trigger foods include cow's milk protein, soy protein, rice, oats, and porcine gelatin, which activate T-cells rather than IgE antibodies like typical food allergies. When an infant or young child consumes a trigger food, their immune system mistakenly identifies the protein as dangerous and launches an inflammatory attack on the gastrointestinal tract, leading to profuse vomiting, diarrhea, and potentially life-threatening dehydration within 2-4 hours of ingestion.

What is the best test for Food Induced Enterocolitis Syndrome?

The Allergen Specific IgE Gelatin Porcine test is the most important blood test for FPIES when gelatin is suspected as a trigger food, as it detects specific IgE antibodies that indicate immune system sensitization to porcine gelatin. While FPIES is primarily diagnosed through clinical evaluation and oral food challenges rather than blood tests, allergen-specific IgE testing helps identify potential trigger foods and guide elimination diets. This testing is particularly valuable because it provides objective data about immune responses to specific proteins without requiring your child to consume potentially dangerous foods, and can help healthcare providers create a safe management plan that avoids severe gastrointestinal reactions and dehydration episodes.

When should I get tested for FPIES?

You should get tested if your infant or young child experiences severe vomiting and diarrhea 2-4 hours after eating certain foods, especially if they show signs of dehydration like lethargy, pale skin, or decreased urination. Testing is also important if your child has repeated gastrointestinal episodes after consuming common trigger foods like milk, soy, rice, oats, or foods containing gelatin, or if they have a family history of food allergies. Early identification of trigger foods through testing prevents dangerous dehydration episodes and allows you to create a safe diet plan before severe reactions occur.

What are the symptoms of FPIES?
FPIES symptoms appear 2-4 hours after consuming a trigger food and include profuse repetitive vomiting, watery or bloody diarrhea, extreme lethargy, and pallor. Children may become severely dehydrated quickly, showing signs like sunken eyes, dry mouth, decreased urination, and listlessness that can progress to shock if untreated. Unlike typical food allergies, FPIES does not cause hives, wheezing, or immediate throat swelling, which is why it is often initially mistaken for stomach flu or food poisoning until a pattern with specific foods emerges.
Who is at risk for FPIES?
FPIES primarily affects infants and young children under age 3, with most cases presenting during the first year of life when new foods are introduced. Children with a family history of food allergies, eczema, or other allergic conditions have an increased risk, as do formula-fed infants when transitioning to cow's milk or soy-based formulas. The condition appears to affect boys and girls equally and can occur in any ethnic group, though the specific trigger foods may vary by dietary patterns and cultural feeding practices in different populations.
What happens if FPIES is left untreated?
Untreated FPIES can lead to repeated severe dehydration episodes that require emergency hospitalization for intravenous fluid replacement and can progress to hypovolemic shock. Chronic exposure to trigger foods causes ongoing intestinal inflammation that results in poor nutrient absorption, failure to thrive, and developmental delays in growing infants and toddlers. Without proper identification and avoidance of trigger foods, children face repeated traumatic medical emergencies, nutritional deficiencies, and potential long-term damage to the gastrointestinal tract that affects their ability to properly digest and absorb nutrients.
Can FPIES be diagnosed with a blood test?
FPIES cannot be definitively diagnosed with blood tests alone because it is a non-IgE mediated allergy that does not produce the typical IgE antibodies measured in standard allergy testing. However, blood tests like the Allergen Specific IgE Gelatin Porcine test play a supportive role by identifying potential trigger foods, ruling out IgE-mediated allergies, and monitoring immune responses over time. The gold standard for FPIES diagnosis remains a supervised oral food challenge conducted by an allergist, combined with detailed clinical history and symptom patterns, but blood work provides valuable information to guide safe dietary management and avoid dangerous exposures.
How is FPIES treated?
FPIES is treated by strictly avoiding all identified trigger foods through careful dietary management and reading food labels to prevent accidental exposure. During acute episodes, immediate medical attention is required for intravenous fluid replacement to treat dehydration and prevent shock, along with supportive care until symptoms resolve. Long-term management involves working with a pediatric allergist and dietitian to ensure proper nutrition while avoiding triggers, gradually reintroducing foods under medical supervision as children grow older, and carrying an emergency action plan since most children outgrow FPIES by age 3-5 though some triggers may persist longer.
How can I prevent FPIES reactions?
You can prevent FPIES reactions by strictly avoiding all identified trigger foods and carefully reading ingredient labels on all packaged foods, since triggers like milk, soy, and gelatin hide in unexpected products. Introduce new foods to infants one at a time with 3-5 days between introductions so you can identify any reactions before adding another food, and keep a detailed food diary noting what your child eats and any symptoms. Inform all caregivers, family members, and daycare providers about your child's specific trigger foods and emergency action plan, and always carry safe alternative foods when traveling or dining out to prevent accidental exposures.
What can I do at home for FPIES?
At home, focus on offering small amounts of clear liquids like an oral rehydration solution if your child has a mild reaction, but seek immediate medical attention if vomiting persists or dehydration signs appear. Keep a symptom diary tracking foods consumed and reactions to help identify patterns and trigger foods, and maintain a well-stocked supply of safe alternative foods that provide complete nutrition without containing known triggers. Work closely with your pediatrician and dietitian to develop meal plans that meet all nutritional needs, and create a written emergency action plan posted in your home so anyone caring for your child knows exactly what to do and when to seek emergency care if an FPIES reaction occurs.
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Allergen Specific IgE Gelatin Porcine
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What's included
Fast & easy, results by email & SMS
No need to visit a doctor
Private & confidential
No insurance needed
Results explained
No extra fees paid at the lab

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