Food Protein Induced Entero-Colitis

Back in the 1980s we had endless spats with the reactionary dinosaurs in the American College of Allergy, Asthma & Immunology. They couldn’t grasp that “food allergy” could cause all kinds of complex symptoms and reactions, not least in the intestines.

It’s just so OBVIOUS it makes you cringe at this ignorance (to the patients’ disadvantage, of course).

There were no antibodies, they said, therefore the whole concept was an illusion or fraud. People could not react to food in this way. The whole idea was called “Mumby-Jumbo” in my home city. Actually, I’m quite proud of that!

Now, some 30 years later, they have FINALLY woken up to the fact that this happens. Actually, it happens a LOT and they haven’t got that far yet. But at least they have changed their tune.

I just saw a study published that’s about what they call food protein-induced enterocolitis syndrome (FPIES). I think food allergy or food intolerance is far simpler!

A case was presented at the American College of Allergy, Asthma & Immunology 2012 Annual Scientific Meeting. Progress!

FPIES and its triggers (most commonly cow’s milk, rice, and soy) can be difficult to diagnose, lead researcher Tara Federly, MD, a fellow at the Children’s Mercy Hospital and the University of Missouri in Kansas City, told Medscape Medical News.

FPIES is not mediated by immunoglobulin (Ig)E, “so it’s not the immediate hypersensitivity reaction that you see with peanut or milk or other allergy,” Dr. Federly explained. “The exact mechanism is not known, but it’s basically an inflammation of the GI tract that is triggered by certain foods. The interesting thing is that it happens hours after ingestion, instead of being a more immediate IgE-mediated reaction,” she said.

Well, we told them that; but they wouldn’t listen! It was antibodies or nothing; no antibodies: patients was deluded and sent to a psychiatrist.

In the case reported by Dr. Federly and her colleagues, which they describe as the first report of orange juice being the causative agent in FPIES, a 2-year-old boy presented with lethargy and severe vomiting that required hospitalization and the administration of intravenous fluids. This occurred on 5 occasions.

Each time, “the emergency department thought that he had viral gastroenteritis, and he returned to normal after intravenous fluid replacement,” Dr. Federly reported.

But the mother spotted it was orange juice. Did they listen to her? No. They never do. Actually, I found Mum’s the absolutely most accurate observers of a child’s symptoms and reactions. But because the possibility of an IgE-mediated food allergy was ruled out on the basis of negative skin-prick testing to orange extract and fresh orange juice, they said mother was stupid and the kid probably a fraud.

“Attention seeking” is the usual way they dismiss it.

However, after fooling around for a long time, somebody had the bright idea of feeding the kid an orange, to see what happened.

You can guess!

Within 90 minutes of the dose of orange, the child began vomiting every 10 to 15 minutes for 2 hours; his heart raced and he felt weary (probably the commonest food allergy reaction of all).

After vigorous hydration, the child responded very well and returned to normal.

Now they have decided other foods can do it: such as be milk, soy, rice, apple, pear, and banana.

Of course the truth is ANY food can do it; they are so s-l-o-w to catch on!

Kids can die from [FPIES]. The reaction is delayed. It happens an hour or 2 after eating the food, so the parents don’t always know what food it was; they don’t even associate it with a food. The doctors, typically, are worse than ignorant. They are arrogant, dismissive and ignorant. Deaths are happening in children less than 1 year of age, young infants, so this might be responsible for crib death.

Yes, I was saying that too back in the 1980s (cot deaths or sudden infant death syndrome).

There’s a case of an infant I wrote up in DIET WISE, who lost virtually all his skin and was sent home to die. It was a potato allergy (but it couldn’t have been, could it? Because potato isn’t on the list).

Are you getting this? I’m really angry at the wasted decades and the millions of lives damaged or destroyed by the jackamuffins at the American College of Allergy, Asthma & Immunology…

[American College of Allergy, Asthma & Immunology (ACAAI) 2012 Annual Scientific Meeting: Abstract P261. Presented November 11, 2011]