Before entering the doctor’s office, it is helpful to have some basic information written down about your child’s symptoms and reactions. To get you started, review the list below and bring your responses with you to the specialist. You may also consider bringing along your child’s food journal for reference.

It can be difficult trying to recall all of the important information during the appointment; bringing an information sheet to your child’s doctor not only helps you to remember what you want to discuss, it also allows the doctor to spend less time writing and more time to consult with you.

Red Flag Symptoms

Acute Symptoms

  • Repetitive vomiting (~1-6 hrs. post ingestion)
  • Diarrhea (~2-10hrs post ingestion)
  • Dehydration (following vomit and diarrhea)
  • Lethargy (with vomiting)
  • Pallor (pale skin, blue/grey tones)
  • Low Blood pressure (hypotension)
  • Low Body Temperature (hypothermia)
  • Abdominal distension

Chronic Symptoms

  • Intermittent/ Chronic vomiting
  • Weight loss
  • Failure to thrive
  • Chronic watery diarrhea with blood/ mucus
  • Lethargy
  • Pallor
  • Abdominal distension

Questions to Consider

  1. What happened?
  2. What were the symptoms experienced by the child?
  3. What was the time course of the child’s symptoms?
  4. How old was the child at the time of the event(s)?
  5. How many times has this happened?
  6. Was it the same every time?
  7. What was the timing from the exposure to the suspected food to the onset of the child’s symptoms?
  8. What foods were involved?
  9. What was done to take care of the child?
  10. How long did it take for the child to recover?
  11. What advice were you given about handling future events?
  12. What tests have been done? Specifically, if your child had any blood tests done at the time of the symptoms, can you get me those results**?

** During an FPIES reaction, the white blood cell count and sometimes the platelet count changes in way that can suggest FPIES– this can further assist in determining a diagnosis.

Other questions will be asked to help rule out those other medical conditions especially infection or food allergy. The selection of tests may depend on whether or not the child is currently having an acute episode or is currently well and has recovered from the event.

To learn what conditions may mimic FPIES symptoms, it may be helpful to review this medical journal article: Differential Diagnosis of Food Protein Induced Enterocolitis Syndrome.

Fiocchi A, Claps A, Dahdah L, Brindisi G, Dionisi-Vici C, Martelli A. Differential diagnosis of food protein-induced enterocolitis syndrome. Curr Opin Allergy Clin Immunol. 2014 Jun;14(3):246-54. doi: 10.1097/ACI.0000000000000057. PMID: 24739227; PMCID: PMC4011629. 

Gratitude Belinda W maybe

Looking to learn more? Read questions taken from the FPIES Q&A with the Medical Advisory Board.

Page published: July 4, 2012. Last update: May 27, 2020. Copyright © 2012, The FPIES Foundation