Some Have Allergic Gut Inflammation After Consuming Rice

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Main Category: GastroIntestinal / Gastroenterology
Also Included In: Pediatrics / Children's Health;  Allergy
Article Date: 01 Nov 2008 - 0:00 PST

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A recent study published in the Archives of Disease in Childhood finds that although most people consider rice to be a "hypoallergenic" food with stomach-settling capabilities, the cereal actually can cause a severe allergic reaction.

Researchers from Australia studied 31 infants, less than 12 months of age, who presented with food protein-induced enterocolitis syndrome (FPIES) - an allergic disorder that causes severe gut inflammation after the ingestion of certain foods. Symptoms include diarrhea and/or vomiting a few hours after consuming the food allergen. Children with FPEIS are often mis-diagnosed with sepsis (blood poisoning) or an abdominal emergency that requires emergency surgery. Usually, FPIES can be traced back to cow's milk and soy proteins. However, it is not unknown for children to be affected by vegetables, meats, and grains.

Of the 31 children studied, episodes of FPIES occurred 56 times over a 16-year period at one children's hospital. Thirty of the episodes could be explained by cow's milk (in ten children) and soy proteins (in seven children). However, rice was the most common trigger of FPIES, responsible for 26 episodes in 14 children. In nine of these children, rice was the sole trigger.

It took, on average, four episodes or instances of presenting symptoms before physicians were able to correctly diagnose that rice was causing the condition. The average time to diagnose cow's milk or soy FPIES was two episodes. Further, rice FPIES led to more severe symptoms than did FPIES due to cow's milk or soy. Forty percent of children suffering from rice FPIES required resuscitation with intravenous fluids, while about 17% required similar treatment when suffering from FPIES due to the other factors.

"This study highlights the emerging importance of rice as a significant trigger of FPIES. Awareness of the entity is fundamental, as the clinical presentation is often confused with an intra-abdominal surgical emergency or sepsis. Multiple presentations before the true diagnosis is established are the norm. Early diagnosis would eliminate repeated reactions and unnecessary investigations. Paediatricians should be aware that rice not only has the potential to cause FPIES, but that such reactions may be more severe than those caused by cow's milk/soy," conclude the researchers.

Rice: a common and severe cause of food protein-induced enterocolitis syndrome
S S Mehr, A M Kakakios, A S Kemp
Archives of Disease in Childhood (2008).
doi 10.1136/adc.2008.145144
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Written by: Peter M Crosta
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