Food Protein-Induced Enterocolitis Syndrome (FPIES) is Associated with Increased Risk of Feeding Disorders
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Jacqueline D Squire, MD, Amy P Stallings, MD
RATIONALE: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE cell-mediated food allergy that may be T cell mediated. Despite recently updated guidelines for diagnosis and management of FPIES, awareness of FPIES in general pediatrics is low. Diagnosis and proper management of FPIES is often delayed, which can lead to adverse outcomes for patients including feeding disorders. We hypothesize that FPIES patients have increased incidence of feeding disorders compared to normal children.

METHODS: FPIES patients were identified using DEDUCE search for a single Duke Pediatric Allergy Clinic site. Families were contacted by phone and asked to complete a 35 question phone survey. Sixty-two patients with FPIES were identified, and 32 patients completed the survey.

RESULTS: 50% (16/32) of patients reported a feeding disorder. 43% (14/32) of patients reported food refusal, 12.5% (4/32) reported trouble swallowing, and 18.8% (6/32) reported a combination of other problems (sensory issues, bottle aversion, and difficulty chewing). Half of patients reported no feeding problems. 50% (8/16) of patients with a feeding disorder reported referral to feeding therapy.

CONCLUSIONS: The incidence of feeding disorders in normal children is estimated at close to 25%. Our findings support the hypothesis that FPIES patients are at increased risk of feeding disorders with 50% of patients reporting a feeding disorder. This is likely due to delays in diagnosis, resulting in repeated reactions of delayed vomiting and subsequent food aversion. Only half of these patients are referred to feeding therapy. This study highlights the need to further examine feeding disorders in the FPIES population.