Food protein-induced enterocolitis syndrome: Disease burden for patients and families.

Abstract

Background: The impact of food protein-induced enterocolitis syndrome (FPIES) extends beyond the direct effects after consumption of an inciting food. Although elimination of the trigger food does alleviate the symptoms of FPIES, it does not address the burden of disease among patients and families living with FPIES. When managing FPIES, consideration should be taken with regard to the potential impact and complications attributed to food avoidance.

Objective: The objective was to review the epidemiology of FPIES and discuss the associated complications of FPIES, such as nutritional deficiencies, food aversions, financial burden, and overall effect on quality of life of patients and families with FPIES.

Methods: A literature review was conducted through the aid of the University of Southern California Norris Medical Library services. Only peer-reviewed sources were used.

Results: The incidence of FPIES ranges from 0.0041 to 0.7%. When compared with individuals with immunoglobulin E (IgE) meditated food allergies, caregivers of children with FPIES reported poor quality of life and increased feeding difficulties. Individuals with multiple trigger foods are more likely to develop food aversion compared with individuals with one food trigger. Failure to thrive, poor weight gain, and nutritional deficiencies can be seen because of food restriction in patients with FPIES and do not just represent presenting symptoms of FPIES.

Conclusion: There was poorer quality of life and increased psychosocial burden among individuals with FPIES and caregivers of individuals with FPIES. Given the associated complications of nutritional deficiency, feeding difficulties, food aversion, and psychosocial stress, FPIES management should involve a multidisciplinary approach that involves nutrition, speech therapy, occupational therapy, and/or mental health services. Further research and data are needed to assess the financial burden of disease on individuals and families affected by FPIES and the long-term impact that FPIES may have on the growth and nutrition.