Alleviating Gasto-Intestinal Discomfort in Infants: Quest for Effective Interventions

Abstract

Functional gastrointestinal disorders (FGIDs) are common among infants, yet precise diagnosis and optimal management strategies remain a challenge. Understanding the prevalence and impact of these conditions is essential for improving infant health. We present a comprehensive review of the evolution of treatment strategies for FGIDs tracing the identification of the first case to the recent advancements in disease management. The article explores the journey of the Rome criteria, which is the most widely used diagnostic parameter for FGIDs, as it transformed from consensus-based recommendations culminating in the present-day evidence-based guidelines, setting the stage for the upcoming Rome V criteria. FGIDs were initially hypothesized solely as a GI entity; however, thorough etio-pathologic research has elucidated the complex bio-psychosocial basis of FGIDs. In infants, these conditions can be particularly challenging to identify and manage due to their limited ability to communicate discomfort and distress. The article briefly refers to pathophysiology and diagnostic challenges as an exploratory background for effective management. An overview of existing research can shed light on the various treatment approaches for FGIDs in infants. We examined pharmacotherapy in FGID management in terms of its indications and limitations, which would allow its judicious use in clinical practice. The article underscores the efficacy and safety of a dietary approach in FGID management in infants, especially in the absence of red flags. We highlight key research details that led to newer advancements in nutritional interventions such as probiotics. L reuteri DSM 17938 is the most extensively studied probiotic with proven benefits and manifold indications. We highly recommend large prospective studies to identify the ideal therapeutic agent that can provide a potential opportunity to prevent FGIDs.