Food aversion and poor weight gain in food protein-induced enterocolitis syndrome: a retrospective study.

Food protein-induced enterocolitis syndrome (FPIES) is a form of non-IgE mediated gastrointestinal food allergy. Insufficient data exist in regards to gastrointestinal history and outcome, particularly comorbidity, family history, food aversion, and poor body weight gain.To identify the gastrointestinal outcomes and related risk factors in FPIES.We analyzed the clinical features and gastrointestinal outcomes of FPIES patients retrospectively at four hospitals in Boston.Two hundred and three FPIES patients were identified, including 180 only with acute FPIES, 8 with chronic FPIES, and 15 with both. Oat (34.5%), rice (29.6%), and cow's milk (19.2%) were the most common food triggers. The prevalence of personal history with allergic proctocolitis (23.2%) and family history with inflammatory bowel diseases (9.4%) and celiac disease (7.3%) were higher than the general population. Compared to the FPIES patients triggered by 1 or 2 foods, the risk of developing food aversion increased in cases triggered by 3 or more foods (adjusted odds ratio (OR) = 3.07 [95% confidence interval (CI), 1.38 - 6.82], P = .006). The risk of poor body weight gain increased in FPIES triggered by cow's milk (adjusted OR = 3.41 [95% CI, 1.21 - 9.63], P = .02) and banana (adjusted OR = 7.63, [95% CI, 2.10 - 27.80], P = .002).Gastrointestinal comorbidities and family history were common in FPIES patients. FPIES patients with 3 or more triggers were at risk of food aversion. Patients with cow's milk and banana triggered FPIES were at risk of poor body weight gain.