Food protein-induced allergic proctocolitis and food protein-induced enterocolitis syndrome Two examples of non-IgE-mediated food allergies

Non-IgE-mediated food allergies are much more frequent in infancy than later in life and occur mainly as food protein-induced allergic proctocolitis (FPIAP) and food protein-induced enterocolitis syndrome (FPIES). The FPIAP is characterized by bloody stools in a good general condition and a benign, usually rapidly self-limiting course. In contrast FPIES occurs in two courses, acute and chronic FPIES. The acute form is characterized by a severe clinical picture with the cardinal symptom of delayed onset of severe vomiting and subsequent volume deficiency. In addition to vomiting the chronic form leads to failure to thrive up to acute exsiccosis. The most common, but not exclusive trigger in both cases is cow's milk protein. This article gives an overview of the differentiation of both diseases as well as the diagnostic and treatment options.