Global FPIES Day Date in the current year: October 14, 2025

Food protein-induced enterocolitis syndrome (FPIES) is a rare type of food allergy characterized by gastrointestinal symptoms. Unlike more common food allergies, which present with symptoms such as rash, hives, itching, and difficulty breathing within seconds after ingesting the trigger food, FPIES presents with symptoms such as severe vomiting and diarrhea within several hours after ingesting the trigger food. If left untreated, these symptoms can lead to dehydration, lethargy, and changes in blood pressure and body temperature.

FPIES is typically caused by food proteins, hence the name. It can develop as early as the first few months of life. In such cases, reactions are usually triggered by cow’s milk or soy protein in baby formula. Some infants may even develop symptoms in response to proteins in breast milk.

Common triggers found in solid foods include grains, especially rice and oats, but these are not the only triggers. Other triggers include milk, soy, poultry and other meats, eggs, fish, shellfish, tree nuts, peanuts, sweet potatoes, green beans, peas, squash, avocados, and bananas. In fact, any food protein can be a trigger. Some triggers can be somewhat region-specific. For example, seafood FPIES seems to be more common in Spain. Some children have an allergic reaction to one or two foods, while others are allergic to multiple foods.

FPIES is difficult to diagnose because it does not involve immunoglobulin E (IgE), so it cannot be diagnosed using standard allergy tests, such as skin prick tests. Instead, diagnosis is based on specific symptoms, such as vomiting within several hours after consuming a suspected trigger food, which may be accompanied by diarrhea. To identify the trigger food, patients may be given small amounts of the suspected food in a controlled clinical environment.

Since the mechanism of FPIES is not yet understood, and since it does not respond to standard antihistamines or epinephrine because it does not involve igE, the only treatment is to avoid known trigger foods. It is important for children with FPIES to follow a personalized dietary plan to ensure they receive proper nutrition.

FPIES episodes are treated with hydration and medications to alleviate nausea and vomiting if the symptoms are mild. Severe reactions, which occur in about 15% of cases, require hospitalization and intravenous fluids.

The good news is that FPIES usually resolves by age 5, if not sooner. However, cases of adult-onset FPIES have been documented, though they are rare. The most common trigger foods for adults are seafood.

Global FPIES Day is spearheaded by the FPIES Foundation, a U.S.-based nonprofit organization that provides support and resources for affected families and healthcare professionals. The day aims to raise awareness of the condition, improve understanding of it, and dispel common myths surrounding FPIES.