A review examined the clinical care of patients with food protein-induced enterocolitis syndrome (FPIES), with an emphasis on existing therapy approaches as well as future possibilities. The following are the most critical management needs after FPIES has been identified and the culprit food has been avoided. First, there has been a return of acute FPIES episodes as a result of inadvertent intake of the suspect food. Giving patients’ relatives a plan of action might be beneficial. Intravenous fluids and steroids are the most commonly recommended therapy, but epinephrine and ondansetron require more research. Oral rehydration should be enough in mild-to-moderate instances. Second, at-risk items should be introduced into the diet. Some meals may be intolerable in children with FPIES, in addition to the culprit(s) mentioned. It has been proposed that certain foods be avoided throughout the baby’s first year. Otherwise, they may be administered for the first time in a hospital setting while undergoing an oral meal challenge. Third, tolerance must be developed. Children with cow’s milk-FPIES have a fair chance of developing tolerance by the age of 18–24 months. Because there is inadequate evidence for other culprit foods to establish the proper period, it is advised that an oral food challenge be undertaken around 1 year after the previous acute episode.

Future clinical therapy of FPIES must consider, among other things, a better knowledge of pathophysiology, the possibility of detecting distinct phenotypes, and the introduction of more effective acute-phase medications. These elements will surely have an impact on management decisions, which will become more diverse and effective.

Reference:journals.lww.com/co-allergy/Fulltext/2014/06000/Clinical_management_of_food_protein_induced.12.aspx