Assessment and Plan

This section contains guidance for an assessment and plan to manage suspected non-IgE mediated food reactions. You can copy and paste it into your EMR system to use during well-child visits or follow up appointments.

Eosinophilic Gastrointestinal Diseases (EGD)

Based on the patient’s reaction, there is a concern for a non IgE mediated food reaction called Eosinophilic Esophagitis. The patient should be referred to a pediatric allergist and/or gastroenterologist for further evaluation. The family was counseled to avoid [INSERT FOOD IF APPROPRIATE] as well as foods they have known allergies to including [LIST KNOWN ALLERGIES OR REMOVE IF N/A]. The family was counseled on label reading, cross contact avoidance and provided with relevant educational materials [NOTE TO DOCTOR TO PROVIDE LABEL READING, CROSS CONTACT PATIENT EDUCATION].

Food Protein-Induced Enterocolitis or FPIES

Based on the patient’s reaction, there is a concern for a non IgE mediated food reaction called Food Protein-Induced Enterocolitis or FPIES. The patient should be referred to a pediatric allergist and/or gastroenterologist for further evaluation. The family was counseled to avoid [INSERT FOOD] as well as foods they have known allergies to including [LIST KNOWN ALLERGIES OR REMOVE IF N/A]. The family was counseled on label reading, cross contact avoidance and provided with relevant educational material [NOTE TO DOCTOR TO PROVIDE LABEL READING, CROSS CONTACT PATIENT EDUCATION]. They were also provided with an FPIES Emergency Plan from the International FPIES Association at www.fpies.org.

Allergic Proctocolitis

Based on the patient’s reaction, there is a concern for a non IgE mediated food reaction called Allergic Proctocolitis (Food Protein-Induced). The family was counseled to avoid [INSERT FOOD] as well as foods they have known allergies to including [LIST KNOWN ALLERGIES OR REMOVE IF N/A]. The family was counseled on label reading, cross contact avoidance and provided with relevant educational. [NOTE TO DOCTOR TO PROVIDE LABEL READING, CROSS CONTACT PATIENT EDUCATION]. If there are any complications or concerns, a referral to a pediatric gastroenterologist will be considered.