Features of drug therapy for functional gastrointestinal disorders in children of preschool and primary school age

Abstract

The article explores modern concepts about functional gastrointestinal disorders in children, considers features of the classification according to the Rome criteria and Russian clinical guidelines, and presents the evolution of views in the context of understanding the general pathophysiological mechanism as impaired “gut-brain” interactions, which leads to dysmotility in different parts of the gastrointestinal tract, visceral hypersensitivity, changes in the local immune system functions, dysbiosis of the gut microbiota and a failure of the central nervous system to process signals. Dysregulation of the central nervous system and the enteric nervous system causes functional gastrointestinal disorders with pain syndrome: irritable bowel syndrome, functional dyspepsia and centrally mediated abdominal pain syndrome. In addition, the article discusses the Russian version of the guidelines due to differences in the diagnostic instrumental and laboratory facilities, as well as national peculiarities of marketing authorization, indications and contraindications for drug use in children. Subject to understanding of the mechanisms of functional gastrointestinal disorders in children, the authors presented information on the role of trimebutine, a universal motility regulator of different parts of the gastrointestinal tract, in the development of functional gastrointestinal disorders, as well as modern approaches to their prevention and correction using a drug of proven efficacy. Numerous national and foreign studies proved the efficacy of trimebutine in hyperkinetic and hypokinetic movement disorders, decreased gastric evacuation function, and impaired gallbladder contractile function in patients with both hypomotor and hypermotor types of functional disorders. The accumulated experience determines the prospects for its use in pediatric practice.