Are we missing food-protein–induced enterocolitis syndrome in adults?

Abstract

Food-protein–induced enterocolitis syndrome (FPIES) remains underrecognized owing to its broad differential diagnosis and lack of confirmatory diagnostic tests. Although awareness of pediatric FPIES is slowly increasing in the medical community, awareness of adult FPIES lags, despite 0.22% of US adults reporting FPIES symptoms.1 The differences in presentation and food triggers contribute to the significantly delayed diagnosis and mismanagement (Table 1). As a result, adults may hesitate to try new foods or medicines owing to lack of understanding of the reason they are now reacting to something they previously tolerated.