The Nest 46: Functional Gastrointestinal disorders in Infants

Editor(s): Yvan Vandenplas. Rodrigo Vazquez Frias, Carlos Lifschitz, Camille Jung. / 46

Functional gastrointestinal disorders (FGIDs) such as regurgitation, colic and functional constipation are very common during infancy. FGIDs are a frequent reason for pediatric consultations, with an estimation of 20-30% consultations during the first months of life being related to FGID. Although they are benign and of favorable outcome, they cause significant parental worry and anxiety. The cornerstone of the management of FGID in infants consists of parental reassurance and guidance. Considering several studies have reported an association between FGID and microbiome alterations, nutritional treatment, focusing on the development and preservation of a healthy gut microbiome has been shown to be effective and safe.

Articles

Functional gastrointestinal disorders in infants : relevance in daily practice

Author(s): Yvan Vandenplas

Worldwide at least 25% of infants suffer from at least one Functional gastrointestinal Disorder (FGID) and more than 75% of them present with more than one FGID. Although FGID are benign and of favorable outcome, there is evidence that they have a long-term impact on the quality of life of the infant and the family and that they are a cause of feeding difficulties. The cornerstone of the management of FGID in infants consists of parenteral reassurance and guidance. Nutritional treatment, focusing on the development and preservation of a heathy gut microbiome has been shown to be effective and safe.

The role of microbiota on infantile colic

Author(s): Rodrigo Vázquez Frias

The etiology of infant colic is suggested to be multifactorial and growing scientific evidence suggests a link between the alterations in gut microbiota and infant colic. The clinical management of this condition includes parental education and reassurance. The treatment with pharmacological agents is not supported by clinical evidence and specific probiotics may be useful, with L. reuteri DSM17938 being  the strain with the highest evidence of efficacy.

Management of infants with gastroesophageal reflux and constipation

Author(s): Carlos Lifschitz

Gastroesophageal reflux and constipation are two of the three more frequent functional gastrointestinal disorders (FGID) in infancy. The cornerstone of the management of FGID in infants consists of parenteral reassurance and guidance. Breastfeeding should not be discontinued as a form of treatment of these conditions. Antiregurgitation formulas can reduce regurgitation in healthy formula fed infants and are part of the treatment guidelines. For constipation, dietary manipulation in formula fed infants in the first year of life is almost impossible except of changing the formula. Probiotics can be an attractive and safe option and prebiotics have been shown to have a beneficial effect in constipation treatment.

Quality of life of infants with functional gastrointestinal disorders

Author(s): Camille Jung

Although functional gastrointestinal disorders (FGID) are benign and of favorable outcome, they cause significant parental worry and anxiety, affecting greatly quality of life (QoL) of infants and parents. QoL is a marker of symptom severity that must be considered in management of the symptoms and therefore should be the primary target of clinical management.