Rice can trigger severe gut reaction in infants

Although rice is considered to have a low potential for causing allergic reactions, it can trigger a severe form of gut inflammation in some infants.

The reaction is known as "food protein-induced enterocolitis syndrome," or FPIES -- an inflammatory response of the digestive system to certain food proteins, including those in cow's milk, soy, meat and grains. Infants with FPIES usually suffer vomiting and diarrhea within roughly 2 hours of eating the culprit food.

While FPIES is similar to a standard food allergy, it does not involve a response from immune system antibodies. And unlike a true food allergy, FPIES usually causes only gastrointestinal symptoms.

Rice, because of its low potential for triggering an allergic response, is generally recommended as the first solid food for infants. However, the grain is increasingly being recognized as a cause of FPIES.

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

What's more, reactions to rice tended to be more severe, with more children requiring IV fluids, the researchers report in the Archives of Disease in Childhood.

Rice remains a hypoallergenic food, and the fact that it can cause FPIES does not change that, said senior study author Dr. Andrew S.

Kemp, of the Children's Hospital at Westmead in Sydney, Australia.

"Parents of children with food allergies do not have to be especially concerned about rice," he told Reuters Health.

The message, Kemp said, is for doctors to be aware that rice can cause FPIES, which is often misdiagnosed as sepsis -- an infection in the bloodstream -- or an acute abdominal problem requiring surgery.

Children with FPIES often have several episodes before the problem is diagnosed, Kemp and his colleagues note, and knowing 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," the researchers write, "but that such reactions may be more severe than those caused by cow's milk/soy."

Bonnie - as I have always said, any food can cause a reaction. We do not recommend rice as the first solid food to introduce because it is a grain. However, after three or four fruits and vegetables, it should be the first grain to introduce.