November 5, 2008

Rice Can Set Off Severe GI Inflammation In Infants

A new Australian study finds that rice can set off a severe form of gut inflammation in some infants. The reaction, known as "food protein-induced enterocolitis syndrome," or FPIES, is an inflammatory response of the digestive system brought about by certain food proteins.  Such proteins are found in soy, cow's milk, meat and grains.

Infants with FPIES typically suffer diarrhea and vomiting within a few hours of eating the offending food.

While similar to a standard food allergy, FPIES does not involve an immune system response. And unlike a true food allergy, FPIES causes only gastrointestinal symptoms.

Because of its low potential for triggering an allergic response, rice has been  generally recommended as the first solid food for infants. However, the grain is increasingly being viewed as a cause of FPIES.

In the new study, researchers found that 14 children came to their hospital with 26 episodes of rice-related FPIES over 16 years. During the same time period, FPIES caused by cow's milk or soy, long considered the most common triggers, occurred in 17 children who had 30 episodes.

The scientists, led by Dr. Andrew S. Kemp, of the Children's Hospital at Westmead in Sydney, Australia, also found that rice reactions had a tendency to be more severe, with children often requiring IV fluids.

"Rice remains a hypoallergenic food, and the fact that it can cause FPIES does not change that," wrote Dr. Kemp in a report about the study.

"Parents of children with food allergies do not have to be especially concerned about rice," he said during an interview with Reuters.

According to Kemp, the message is for doctors to be aware that rice can trigger FPIES, which is often misdiagnosed as the bloodstream infection sepsis or an acute abdominal condition requiring surgery.

Children with FPIES often have many episodes before becoming accurately diagnosed, Kemp and his colleagues said.   They hope the knowledge that rice is a potential cause of severe digestive symptoms may lead to earlier diagnosis.

"Pediatricians should be aware that rice not only has the potential to cause FPIES," they wrote, "but that such reactions may be more severe than those caused by cow's milk/soy."

The study was published online in the October 28, 2008 Archives of Disease in Childhood.


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