Differential diagnosis of FPIES in adults
| Diseases | Signs and symptoms that can distinguish the condition from FPIES |
|---|---|
| Small intestinal bacterial overgrowth (SIBO) | Bloating, flatulence, and abdominal discomfort with diarrhea or constipation. Diagnosis with a carbohydrate breath test or jejunal aspirate culture |
| Inflammatory bowel disease | Diarrhea, abdominal pain, rectal bleeding, and weight loss, but not related to intake of a specific food |
| Irritable bowel syndrome (IBS) | Abdominal pain and changes in bowel habits (constipation and/or diarrhea) and in stool form |
| Lactose intolerance | Bloating, cramps, diarrhea, borborygmi, and vomiting after ingestion of milk or dairy products with lactose |
| Fructose intolerance | Bloating, flatulence, or diarrhea after ingestion of fruit and fruit-based sweeteners |
| Celiac disease | No temporal relationship between symptoms and specific food intake, progressive malabsorption, and positive celiac serology |
| Eosinophilic gastroenteritis | Symptoms more chronic than episodic, vomiting less severe, and more likely to have positive IgE test results, usually not associated with specific food intake |
| FPIES | Abdominal pain, diarrhea, vomiting related to specific foods (especially seafood, eggs, etc.) |
| Intolerance of short-chain fermentable carbohydrates | Flatulence, abdominal pain, bloating, or diarrhea after foods containing fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is variably referred to as carbohydrate intolerance |
