see also: [[anaphylactoid]] see: [RCH - Non-IgE mediated food allergy](https://www.rch.org.au/clinicalguide/guideline_index/Non-IgE_mediated_food_allergy/) #paeds #incomplete > Any bilious [[Vomiting]] requires consideration of alternative cause and surgical opinion ![[Pasted image 20250623135038.png]] > [!caption] **Note:** CMPI (Cow’s Milk Protein Intolerance) is an umbrella term still used by many clinicians, which encompasses the non-IgE-mediated allergic conditions Food Protein-Induced Allergic Proctocolitis and Food Protein-Induced Enteropathy **Food Protein-Induced Allergic Proctocolitis (FPIAP):** delayed, non-IgE-mediated inflammation of the rectum, commonly presenting in first few months of life. Stools with blood +/- mucous. Infant usually well and thriving **Food Protein-Induced Enteropathy:** delayed, non-IgE-mediated inflammation of the small intestine, commonly presenting in early infancy. Persistent loose stools, vomiting is common and there may be poor weight gain. Child can be unsettled and may have secondary lactose malabsorption, leading to bloating and peri-anal excoriation **Food Protein-Induced Enterocolitis Syndrome (FPIES):** delayed onset of repeated vomiting, on average 2-4 hours after ingestion of trigger food. May be associated with pallor, lethargy and may have loose stools. Usually presents in first year of life following introduction of solid foods. The most common trigger foods in Australia are rice, cow milk, soy or oats, however it can be caused by any food.