Regurgitation In Infants Research Articles

Diagnostic Outcome of Rome IV Criteria in Diagnosis of Functional Constipation among Infants and Children

Abstract Background Functional Constipation is one of the most prevalent functional gastrointestinal disorders (FGIDs) among children worldwide. Rome IV criteria is used to diagnose functional constipation. The use of Rome questionnaire for screening also reveals other associated FGIDs. Objective To assess the outcome of Rome IV criteria in diagnosis of functional constipation among infants and children and follow up of cases to uncover any organic causes among them. Methods Cross-sectional, controlled study on 121 patients diagnosed as constipation with no red flags, selected from Pediatric Gastroenterology & General Clinics in Ain Shams University, Egypt. Patients were divided into 2 groups, below 4 years old (21 patients) and above 4 years old (100 patients) based upon the age stratification of the Rome criteria which was applied to all patients. Results There was nearly equal gender affection with a median age of 10 months among patients younger than 4 years, and a median age of 7 years old among patients older than 4 years. It was found that 38.1% of infants had a mixed diagnosis, where infant colic and regurgitation occurred in 9.5% and 33.3% of cases respectively. While among the group above 4 years old, Functional Dyspepsia represented the most common associated FGID (64%), followed by Aerophagia (8%), then Functional Vomiting (5%), while Abdominal Migraine and Functional Nausea represented 3% and 1% of all cases respectively. Upon follow up none of the patients developed any organic disease. Conclusion We concluded that diagnosis and follow up of patients using Rome IV is efficient in excluding organic diseases and diagnosing functional constipation (FC) and it avoids the need for further investigations. Moreover, Rome questionnaire was able to detect other FGIDs associated with constipation.

Diagnostic Outcome of Rome IV Criteria in Infant Regurgitation

Abstract Background Infant regurgitation is the most prevalent functional gastrointestinal disorder (FGID) occurring in the first year of life. In 2016 Rome IV criteria was launched with criteria for diagnosis of infantile FGIDs including regurgitation. Objectives The aim of this study is to follow up cases of infant regurgitation diagnosed by applying Rome IV criteria among neonates and toddlers and reevaluate them to uncover any organic causes among them. Methods A prospective cohort study was conducted at the general outpatients’clinic, Children’s Hospital, Ain-Shams University included 280 cases fulfillingRome IV criteria with 3 months for recruitment of patients followed by 3 months follow of each case. Full history and clinical examination were performed with special focus on anthropometric measurements. Results from 280 cases 42.9% totally cured (stopped regurgitation), 49.6% partially improved (decreased number of regurgitation episodes per day) and 7.5% didn’t improve (still have the same number of regurgitations per day) with proper weight gain. However, only 3 cases showed failure to thrive which is not related to regurgitation. Conclusion None of our cases diagnosed as infant regurgitation by Rome IVcriteria developed any organic diseases during period of follow up indicating the accuracy of Rome IV criteria in excluding organic diseases.

Infant formulas for the treatment of functional gastrointestinal disorders: A position paper of the ESPGHAN Nutrition Committee.

Functional gastrointestinal disorders (FGID), such as infant regurgitation, infant colic, and functional constipation, are common and typically physiological phenomena during the early months of an infant's life and account for frequent consultations with pediatricians. Various infant formulas are marketed for their management and are frequently given by parents to infants before a medical consultation. However, the evidence supporting their effectiveness is limited and some have altered nutritional compositions when compared to standard formulas. Thus, these products should only be used under medical supervision and upon medical advice. Marketing and over-the-counter sales do not ensure proper medical guidance and supervision. The aim of this position paper is to review the current evidence regarding the safety and efficacy of formulas specifically formulated for addressing regurgitation, colic, and constipation, recognized as FGID. The objective is to provide guidance for clinical management based on the highest quality of available evidence. A wide search using Pubmed, MEDLINE, EMBASE and Cochrane Database of Systematic Reviews was performed including the MESH terms infant formula, colic, constipation, regurgitation, reflux, palmitate, lactase, lactose, magnesium, hydrolyzed protein, prebiotics or probiotics. 752 papers were identified and screened. Finally, 72 papers were included in the paper. In the absence of evidence, recommendations reflect the authors' combined expert opinion. Final consensus was obtained by multiple e-mail exchange and meetings of the Nutrition Committee. (1) For breastfed infants experiencing FGID such as regurgitation, colic, or constipation, transitioning from breastfeeding to commercial formulas is not recommended. (2) In general, whether an infant is breastfed or formula-fed, it's crucial to reassure parents that FGIDs are normal and typically do not necessitate treatment or change to a special formula. (3) Thickened formulas, often termed anti-reflux formulas, may be considered in specific cases of regurgitation. (4) The usage of specialized formulas for infants with colic is not advised due to a lack of clinical evidence. (5) In the case of constipation in infants, the use of formulas enriched with high β-palmitate and increased magnesium content may be considered to soften the stool. Generally, there is limited evidence supporting the use of specialized formulas for FGID. Breastfeeding should never be discontinued in favor of formula feeding.

Relationship Between Health Education on Breastfeeding Techniques and Burping Babies After Breastfeeding With Regusrgitation Incidents in Babies in Panyaungan Village in 2023

Background Regurgitation in infants is often caused by physiological reflux, which is a normal condition. The lower esophageal sphincter in infants is not fully mature, so food can go back up into the esophagus and out through the mouth. Purpose of Writing: for the relationship between health education on breastfeeding techniques and burping babies after breastfeeding with the incidence of regurgitation in babies in Panyaungan Village in 2023. Research Methods: The sample size in this study used a total side, namely 65 mothers who had babies aged 0-6 months in Panyaungan Village who were taken by total sampling. Collecting data to determine mother's knowledge about breastfeeding techniques and burping babies and the incidence of regurgitation was measured using a questionnaire. The data analysis used is the method of this research is an analytic survey with a case control design or retrospective study. Research Results In the chy-square test, the results obtained were P value 0.000 > 0.05, so the analysis was that there was a relationship between burping techniques and regurgitation events in Panyaungan Village in 2023. The OR calculation results were 5.556, which means that babies aged 0-6 months have more regurgitation events 5.556 times higher by not or rarely doing burping techniques compared to doing burping techniques (95% CI 3.075 -10.038. Conclusions and Suggestions: It is hoped that the results of this study can be used as a reference that in order to reduce regurgitation it is necessary to provide education on breastfeeding techniques until breastfeeding mothers understand proper and correct breastfeeding techniques.

Screening for functional gastrointestinal disorders in preterm infants up to 12 months of corrected age: a prospective cohort study

Functional gastrointestinal disorders (FGIDs) are characterized by a variety of symptoms that are frequently age-dependent, chronic, or recurrent and are not explained by structural or biochemical abnormalities. There are studies in the literature reporting different results regarding the relationship between prematurity and FGIDs. The main objective of this study was to compare the frequency of FGIDs between preterm and term infants. The secondary objective was to evaluate whether there was any association between neonatal characteristics and development of FGIDs. A multicenter prospective cohort study that included preterm infants born before 37 weeks of gestation and healthy term infants was carried out. At 1, 2, 4, 6, 9, and 12 months of age, infants were assessed for the presence of FGIDs using the Rome IV criteria. In preterm infants, an additional follow-up visit was made at 12 months corrected age. 134 preterm and 104 term infants were enrolled in the study. Infantile colic, rumination syndrome, functional constipation, and infant dyschezia were more common in preterm infants. Incidence of other FGIDs (infant regurgitation, functional diarrhea and cyclic vomiting syndrome) were similar among preterm and term infants. Preterm infants who are exclusively breastfeed in the first 6 months of life have a lower incidence of infantile colic (18.8% vs 52.1%, p = 0.025). In terms of chronological age, FGIDs symptoms started later in preterm infants; this difference was statistically significant for infantile colic and regurgitation (median age 2 months vs 1 month, p < 0.001). Conclusions: Preterm infants have a higher prevalence of FGIDs compared with term controls. Therefore, especially if they have gastrointestinal complaints, they should be screened for FGIDs. Possibly due to maturational differences, the time of occurrence of FGIDs may differ in preterm infants. Infantile colic incidence decreases with exclusive breastfeeding.What is Known:• The functional gastrointestinal disorders are a very common in infancy.• Data on preterm infants with FGIDs are currently very limited.What is New:• Preterm infants have a higher incidence of infantile colic, rumination syndrome, functional constipation and infant dyschezia when compared to term infants.• Preterm infants who are exclusively breastfed during the first 6 months of life experience a lower incidence of infantile colic.

Dietary fiber pectin: challenges and potential anti-inflammatory benefits for preterms and newborns.

Pectins, a class of dietary fibers abundant in vegetables and fruits, have drawn considerable interest due to their potential anti-inflammatory properties. Numerous studies have indicated that incorporating pectins into infant formula could be a safe strategy for alleviating infant regurgitation and diarrhea. Moreover, pectins have been shown to modulate cytokine production, macrophage activity, and NF-kB expression, all contributing to their anti-inflammatory effects. Despite this promising evidence, the exact mechanisms through which pectins exert these functions and how their structural characteristics influence these processes remain largely unexplored. This knowledge is particularly significant in the context of gut inflammation in developing preterm babies, a critical aspect of necrotizing enterocolitis (NEC), and in children and adults dealing with inflammatory bowel disease (IBD). Our mini review aims to provide an up-to-date compilation of relevant research on the effects of pectin on gut immune responses, specifically focusing on preterms and newborns. By shedding light on the underlying mechanisms and implications of pectin-mediated anti-inflammatory properties, this review seeks to advance our knowledge in this area and pave the way for future research and potential therapeutic interventions.

Prevalence of functional gastrointestinal disorders in Saudi infants and toddlers: A cross-sectional multicenter study.

Functional gastrointestinal disorders (FGIDs) are common pediatric problems, but their prevalence in Saudi Arabia is unknown. We aimed to assess the prevalence of FGIDs and risk factors among children in six regions of Saudi Arabia. This was a cross-sectional multicenter study enrolling children aged 0-48 months, attending pediatric clinics. Questionnaires evaluated the clinical history, symptoms, and sociodemographic information. FGIDs were defined according to Rome IV criteria. The study involved 1011 infants and toddlers (mean [standard deviation (SD)] aged, 21.7 [19.4] months; FGIDs and mean [SD] age 17.4 [16.4] months; controls). FGIDs were diagnosed in 483 (47.7%) of all infants and toddlers. The prevalence of FGIDs was significantly higher in children aged 0-12 months than in those aged 13-48 months ( P < 0.001). The most common disorders were functional regurgitation (13.8%) in infants and functional constipation (9.6%) in toddlers. Univariate regression analysis confirmed that the rate of FGIDs was higher in term gestational age infants (odds ratio (OR) 2.7; 95% confidence interval (CI), 1.76-4.17, P < 0.001), in partial breastfeeding (OR 0.58; 95% CI, 0.40-0.84, P = 0.003), in formula feeding (OR 2.25; 95% CI, 1.51-3.35, P < 0.001), and in subjects with no history of food allergy (OR 2.40; 95% CI, 1.58-3.64, P < 0.001). FGIDs are common in Saudi infants and toddlers (47.7%). Regurgitation is most prevalent in infants, and functional constipation is most common in toddlers. Term gestational age infant, partial breastfeeding, formula feeding, and subjects with no history of food allergy are associated with the prevalence of FGIDs.

Efficacy of an extensively hydrolyzed formula with the addition of synbiotics in infants with cow's milk protein allergy: a real-world evidence study.

Cow's milk protein allergy (CMPA) is the most frequent food allergy in early childhood. For those infants requiring breastmilk substitutes, formulas with extensively hydrolyzed proteins (EHF), should be the treatment of choice. As there are limited data showing the progression of initial symptoms in infants newly diagnosed with CMPA who are treated with EHF with added synbiotics, the main objective of this study was to evaluate the resolution of symptoms in said infants after 4 weeks of treatment. As a secondary objective this study aimed to assess the impact of the treatment on the family's quality of life. observational, longitudinal, prospective, and multicentric real-world evidence study. The intervention phase (EHF with synbiotics) lasted 28 days and was completed by 65 patients. Treating physicians registered child´s anthropometry, Infant Gastrointestinal Symptoms Questionnaire (IGSQ-13) and CoMiSS (Cow´s Milk Allergy Symptoms Score) both at baseline and after 28 days of treatment. During treatment, caregivers reported child´s regurgitation and stools, PO-SCORAD (Patient Oriented Scoring of Atopic Dermatitis) and FAQL-PB (Family Quality of Life-Parental Burden). Data were collected using Google Forms and analyzed through the STATA program. 95.4% of the patients showed an improvement or disappearance of the overall initial symptoms after 4 weeks of treatment. Gastrointestinal symptoms improved or disappeared in 92% of patients (p < 0.05) while dermatological symptoms improved or disappeared in 87.5% of patients (p < 0.05). The median CoMiSS at baseline was 9, with 21 patients exceeding the cut-off point of 12. After 4 weeks of treatment, the median dropped to 3, and no patient exceeded the 12-cut-off point (p = 0.000). At baseline, patients had a PO-SCORAD of 11.5 (interquartile range 1-23) that went to 1.0 (interquartile range 1-6) at day 28 (p = 0.000). The treatment diminished stool frequency (p < 0.05), improved stool consistency (p = 0.004) and decreased the frequency of regurgitation in infants with CMPA (p = 0.01). The percentage of patients who no longer had any episode of regurgitation increased from 11% to 31% on day 28 (p = 0.003). At baseline, 13% of patients cried more than 3 h per day, while at day 28 that percentage dropped to 3% (p = 0.03). An improvement in the infants' sleep pattern was also appreciated with the treatment. At study onset, 56% of the families reported feeling very overwhelmed, a percentage that dropped to 17% after 28 days of treatment (p < 0.05). The small percentage of families who did not feel overwhelmed at study onset (17%), grew to 43% on day 28 (p < 0.05). The use of an EHF with synbiotics for the management of infants diagnosed with or suspected to have CMPA suggested a good safety profile, an adequate infant growth, and improvement of overall, gastrointestinal, and dermatological symptoms. It also suggested a lower daily frequency of regurgitations and stools, and an improvement in stool consistency, sleeping pattern, and quality of life of the infant and his family.

The use of an electronic version of nutrition recommendations and a specialized product for lactating women in a set of measures to support lactation

Breastfeeding (BrF) provides significant health benefits for both the baby and the mother. At the same time, it is known that suboptimal nutrition of a woman during lactation can affect the health of children both in the short and long term, as well as shorten the duration of breastfeeding. In this regard, a set of measures to support breastfeeding should include raising women’s awareness of nutrition issues during lactation, and for the formation of a full-fledged balanced diet. It is advisable to use specialized products for nursing mothers, which is especially important in hypogalactia or suspected hypogalactia.&#x0D; Materials and methods. The analysis included the results of a survey of women and medical records of children of one hundred eighty one mother-child couple. The questionnaires were completed by women who used the electronic version of the dietary re­commendations during breastfeeding. Depending on the rate of weekly weight gain in infants, lactating women were divided into &#x0D; 2 groups: women with sufficient lactation (n = 114); women with hypogalactia or suspected hypogalactia (n = 67). In addition to the recommendations of a set of measures to stimulate lactation, given to women, the use of a specialized product for lactating women of domestic production was recommended to correct the diets of women with suspected hypogalactia or its presence. To assess the quality of life of women, a short version of the WHO quality of life questionnaire — WHOQOL-BREF was used.&#x0D; Results. 96.1% of female respondents rated the recommendations as useful and effective. After 30 days from the start of comply the recommendations, the number of women who highly assess their level of knowledge on nutrition during lactation increased from 38.7% to 63%. In 82.9% of cases, women were able to successfully adjust the diet, and in 81.2% of cases — to expand it. Upon repeated questioning after 30 days breastfeeding was revealed to preserve in 96.7% of cases in general among both surveyed groups. In both groups, the duration of crying and the volume of regurgitation in infants significantly decreased, which may be due to the correction of the mothers’ diet.&#x0D; Conclusion. An integrated approach to lactation support with the provision of an electronic version of information materials on the nutrition of nursing women, as well as the inclusion of a specialized product for lactating mothers in the diet of nursing women, made it possible to preserve breastfeeding and improve the quality of life in terms of “Physical and psychological well-being”, including women with hypogalactia.

Effectiveness of a starch thickened infant formula with reduced lactose content, probiotics and prebiotics on quality of life and clinical outcome in infants with regurgitation and/or colic.

Regurgitation and colic are quite common in young infants, leading to a reduced quality of life (QoL) and to parental distress. Their management is challenging and aims to effectively reassure and relieve symptoms. This study aimed to assess the effectiveness over 30 days of a starch thickened formula with a reduced lactose content, Limosilactobacillus reuteri (Lactobacillus reuteri) DSM 17938 and FOS/GOS. A real-world prospective multicenter experimental study was conducted in a before-after design within subject. Full term infants 0-5 months with regurgitation or colic or both symptoms and without intercurrent illness were included after parental informed consent and received the studied formula. The primary endpoint was the improvement in QoL using the QUALIN infant's questionnaire. Secondary endpoints were the symptoms outcome and the formula tolerance. Of the 101 infants included (age: 6.2 ± 4.3 weeks), 33 had regurgitation, 34 colic and 34 had both. At D30, the QoL score was improved in 75% of infants in per protocol analysis (n = 68; +8.2 ± 13.7; p < 0.001), more in those with colic or both symptoms. Meanwhile, in intention to treat analysis (all p < 0.001), the daily number of regurgitations decreased by 61% and the weekly number of days with colic by 63% while the daily cumulative duration of crying decreased by 82 ± 106 mn. These improvements were observed within the first week by 89 and 76% of parents, respectively. The study formula associated with reassurance is shown to be quickly effective in the management of infant's regurgitation or/and colic in routine clinical practice. https://clinicaltrials.gov/, identifier NCT04462640.

Supporting families in the management of gastroesophageal reflux disease in children

Gastroesophageal reflux disease (GERD) in children is a frequent reason for medical consultation. Itis defined as the involuntary passage of gastric contents into the esophagus, with or without regurgitation and vomiting. It can become pathological if it leads to embarrassing symptoms and complications. Often confronted with this pathology, nursery nurses sometimes find themselves at a loss when it comes to treating the symptoms of pathological GERD in a toddler, as well as in supporting the parents. In order to give them some ideas, a review of the literature on the benefits of non-medicinal strategies on regurgitation in full-term infants with pathological GERD was conducted.

Neonatal risk factors for functional gastrointestinal disorders in preterm infants in the first year of life.

An assessment of functional gastrointestinal disorders (FGIDs) in premature infants in their first year of life and neonatal factors influencing the progression of FGIDs was conducted in this research. Subjects selected for the retrospective study involved preterm infants being hospitalized in the neonatal department of Northern Jiangsu People`s Hospital from September 2018 to September 2021. Data on neonatal risk factors such as gestational age, gender, birth weight, mode of delivery, feeding pattern, antibiotic administration and addition of probiotics, duration of hospitalization, maternal history of smoking, and mental health status, were all collected and analyzed. FGIDs were diagnosed according to Rome IV criteria. This study included 988 preterm infants, with 725 (73.4%) having at least one FGID, 449 (45.4%) with infant colic, 411 (41.6%) with infant regurgitation, 237 (24.0%) with infant dyschezia, 190 (19.2%) with functional constipation, and 34 (3.4%) with functional diarrhea throughout the first year of life. In total, 263 infants (26.6%) without FGID symptoms were included in the control group. Further, a higher prevalence of FGIDs was observed in preterm infants with infant colic as well as infant regurgitation in particular as being characterized by a low gestational age ( < 32 w), low birth weight ( < 1.5 kg), Cesarean section, formula feeding, neonatal antibiotics use, hospitalization longer than 7 days, and maternal history of smoking. It was found from association analyses that infants exclusively breastfed in their first month of life were at lower risk for regurgitation than those in the control group. Unnecessary antibiotic use in the neonatal period, Cesarean delivery, passive smoking, lack of breastfeeding along with inappropriate probiotics usage are major risk factors for FGIDs, and their systematic control may be effective in reducing the susceptibility to and prevalence of FGIDs in preterm infants in the first year of life.

Digestive Tolerance and Safety of an Anti-Regurgitation Formula Containing Locust Bean Gum, Prebiotics and Postbiotics: A Real-World Study.

Infant regurgitation is associated with other functional gastrointestinal disorders and signs and symptoms that have a major impact on the quality of life of infants and their families. This study evaluated the safety, tolerance, and real-world effectiveness of an anti-regurgitation formula containing locust bean gum (LBG), prebiotics, and postbiotics to alleviate digestive symptoms beyond regurgitation. This 3-month study involved infants with regurgitation requiring the prescription of an anti-regurgitation formula according to usual clinical practice. Outcomes included evaluation of the evolution of stool consistency and frequency; occurrence of colic, constipation, and diarrhea; and assessment of regurgitation severity. Infant crying, parental assessment of infant well-being, and parental satisfaction with the stool consistency were also evaluated. In total, 190 infants (average age: 1.9±1.1 months) were included. After three months, stool frequency and consistency remained within the normal physiological range, with 82.7% of infants passing one or two stools per day and 90.4% passing loose or formed stools. There was no significant increase in the number of infants with diarrhea, whereas a decrease was observed in the number of infants with constipation after 1 month (p=0.001) and with colic after both 1 and 3 months (p<0.001). Regurgitation severity and crying decreased and parental satisfaction with stool consistency, formula acceptability, infant well-being, and sleep quality increased. Monitoring of adverse events did not reveal any safety concerns. Formulas containing LBG, prebiotics, and postbiotics were well tolerated and provided an effective strategy for managing infant regurgitation and gastrointestinal discomfort.

Outcome of Infant Regurgitation Diagnosed by Rome Ⅳ Criteria

Outcome of Infant Regurgitation Diagnosed by Rome Ⅳ Criteria

Indonesian pediatricians’ understanding and management of infant regurgitation based on Rome IV criteria

Background The diagnostic criteria of infant regurgitation have been well elucidated in the Rome IV criteria and pediatricians have been informed of them. However, as a functional disorder, infant regurgitation is susceptible to misdiagnosis and inappropriate management.&#x0D; Objective To assess pediatricians’ diagnostic knowledge of and therapeutic approach to infant regurgitation.&#x0D; Methods We conducted a cross-sectional, analytical study using a questionnaire based on Rome IV criteria for infant regurgitation diagnosis and standardized guidelines for management. The questionnaire was face-level validated by an expert and tested for both reliability and correlation using 30 test respondents. The questionnaire was then distributed electronically to 131 randomized pediatricians, who were members of the Indonesian Pediatric Society DKI Jakarta branch and graduated from pediatric residency within year 2005-2019.&#x0D; Results Sixty-seven (51%) pediatricians reported applying the Rome IV criteria in daily clinical practice. Pediatricians who used Rome IV as their source of knowledge achieved mean and median diagnostic knowledge scores of 14.87 (SD 2.540) and 16 (range 8–20), respectively, with no significant correlation between the usage of ROME IV and the pediatricians’ diagnostic understanding (P=0.110), and mean and median therapeutic knowledge scores of 9.10 (SD 2.264) and 10 (range 4–12), respectively, with no significant correlation between the usage of ROME IV and the pediatricians’ therapeutic approach (P=0.486). Pediatricians’ diagnostic knowledge and therapeutic approach were not significantly different with regards to their practice experience, specialist institution, workplaces, and source of information.&#x0D; Conclusion The majority of pediatricians surveyed have good diagnostic and therapeutic knowledge scores with regards to handling of Rome IV infant regurgitation.

Impact of Functional Gastrointestinal Disorders in Infancy and the Role of Nutrition

Functional gastrointestinal disorders (FGIDs) such as infantile colic, constipation and colic occur in almost half of the infants. Functional gastrointestinal disorders (FGID) are common among children and may cause a significant symptom burden. The Rome criteria are symptom-based guidelines for the assessment of FGID among children and adults. The most common FGID for children aged 0–12 months was infant regurgitation, the most common FGID for those aged 13–48 months were functional constipation and cyclic vomiting, and, for those aged over four years, functional constipation, functional dyspepsia, and irritable bowel syndrome. This reported overall incidence of FGID may be used as a benchmark of normative data among the general population and comparative data for those with comorbid disease. The aim of this mini review article is to provide a critical and updated review on the management of FGIDs and their impact on the health of the infant and family to health care physicians. Guidelines and expert recommendations were reviewed. FGIDs are a frequent cause of parental concern, impairment in quality of life of infants and relatives, and impose a financial burden to families, health care, and insurance. Therefore, primary management of the FGIDs should be focused on improving the infants’ symptoms and quality of life of the family. If more than parental reassurance is needed, available evidence recommends nutritional advice as it is an effective strategy and most of the time devoid of adverse effects. The role of healthcare providers in reassuring parents and proposing the correct behavior and nutritional intervention by avoiding inappropriate use of medication, is essential in the management of FGIDs.

Eosinophilic gastrointestinal disorders in childhood

Eosinophilic gastrointestinal disorders are a group of chronic inflammatory conditions characterised by the presence of eosinophilic infiltrates in the gastrointestinal wall. These disorders include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis, and eosinophilic colitis. Their incidence is increasing, with eosinophilic esophagitis known to be the most common form. The etiopathogenesis of eosinophilic gastrointestinal disorders is not fully understood, and most likely associated with an abnormal immune response to food and/or inhalant allergen. They are often accompanied by allergies. Clinical symptoms, especially in the youngest children, are non-specific and depend on the gastrointestinal segment involved. These are most often feeding difficulties and regurgitation in infants, and heartburn, chest pain, dysphagia and food bite impaction in adolescents and adults. Except for eosinophilic esophagitis, there are no uniform diagnostic or therapeutic guidelines for eosinophilic gastrointestinal disorders. Diagnosis is challenging and it is based on the coexistence of clinical, endoscopic and histopathological symptoms and the exclusion of secondary causes of gastrointestinal eosinophilic infiltration. Treatment involves the use of proton pump inhibitors, an elimination diet, or glucocorticoid therapy. Endoscopic or surgical treatment may be necessary in some cases. Clinical remission does not correlate with histopathological remission, therefore monitoring of therapeutic effects requires multiple endoscopies with histopathological assessment of specimens. The aim of this paper was to present the current data on the incidence, diagnosis and treatment of eosinophilic gastrointestinal diseases in children.

Prematurity and functional gastrointestinal disorders in infancy: a cross-sectional study.

ABSTRACTBACKGROUND: Functional gastrointestinal disorders (FGIDs) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms that are not explained by structural or biochemical abnormalities. Their relationship with prematurity has been increasingly studied.OBJECTIVE: To compare the frequency of FGIDs in preterm and term infants and to evaluate whether invasive procedures during the neonatal period in preterm infants are associated with greater likelihood of FGIDs in the first two years of life.DESIGN AND SETTING: Controlled nested cross-sectional study conducted in a Brazilian university hospital.METHODS: This was a controlled nested cross-sectional study on a retrospective cohort of infants born preterm who were compared with infants born at term regarding the presence of FGIDs. Medical consultations were conducted by a single pediatric gastroenterologist to obtain information on the gestational and neonatal periods and on clinical manifestations of the digestive tract. The Rome IV criteria for the diagnosis of FGIDs were used.RESULTS: A total of 197 infants (< 24 months), including 99 preterm and 98 term infants, were studied. Infant regurgitation was more prevalent in term infants (35.1% and 15.6%; P < 0.001). The frequencies of other FGIDs (infant colic, functional constipation, functional diarrhea and infant dyschezia) in preterm infants did not differ from those of term infants (P > 0.05). No relationship was found between invasive procedures during the neonatal period and development of FGIDs in preterm infants.CONCLUSION: Infants born preterm did not have higher frequency of FGIDs in the first two years of life.

Prevalence of Functional Gastrointestinal Disorders in Brazilian Infants Seen in Private Pediatric Practices and Their Associated Factors

To assess the prevalence of the most frequent functional gastrointestinal disorders (FGIDs) in Brazilian infants seen in private pediatric clinics and their relationship with cesarean delivery, breastfeeding, and history of prematurity. This cross-sectional study enrolled 5080 infants under 12 months old with routine visits in private pediatric clinics in Brazil. The mothers answered questions about the type of delivery, type of feeding (breast milk, infant formula, cow milk, mixed feeding), history of prematurity, and gastrointestinal symptoms. Rome IV criteria were used to diagnose FGIDs. The prevalence of infant regurgitation was 10.7% (487/4560); infant colic, 6.1% (131/2162); infant dyschezia, 4.0% (157/3895); functional constipation, 7.6% (341/4506); and functional diarrhea, 0.09% (2/2186). Prematurity was associated ( P < 0.05) with infant regurgitation (odds ratio [OR] = 1.41; 95% confidence interval [CI]: 1.05, 1.90), infant colic (OR = 1.97; 95% CI: 1.19, 3.24), infant dyschezia (OR = 1.64, 95% CI: 1.02, 2.64), and functional constipation (OR = 1.44; 95% CI: 1.02, 2.02). Prematurity was associated ( P < 0.001) with two or more FGIDs between 21 days and 150 days of age (OR = 3.06; 95% CI: 1.74, 5.37). FGIDs are common in infants seen in the private pediatric practice in Brazil. History of prematurity was associated with infant regurgitation, infant colic, functional dyschezia, and functional constipation.

Prevalence and risk factors of functional gastrointestinal disorders in Vietnamese infants and young children

BackgroundFunctional gastrointestinal disorders (FGIDs) are common early in life. The prevalence of FGIDs varies among countries but is unknown in Vietnam. The aim of this study is to assess the prevalence of FGIDs in healthy Vietnamese infants and young children.MethodsThis was a cross-sectional, observational study involving healthy infants and young children between 0 – 48 months old in Hanoi, Vietnam. A representative total of 1511 subjects completed the validated questionnaire on paediatric FGIDs. Rome IV criteria were used to define FGIDs.ResultsFor Vietnamese infants (0–6 months) and young children (7–48 months), the prevalence of having at least one FGID was 10.0% and only 0.6% was having more than one FGID. Infantile regurgitation (9.3%) was the most prevalent FGID among infants 0—6 months of age while all other FGIDs had a low prevalence between 0—2.5%. For young children between 7 – 48 months old, functional constipation was the most common disorder at the rate of 5.6%. Association analysis revealed that the risk of infant regurgitation was significantly lower among infants with exclusively breastfeeding at 2 – 3 months and 3 – 4 months, formula initiation at 0 – 1 months, and higher paternal education level. The prevalence of functional constipation was significantly higher in male subjects, children in families with annual household income between 273,000,000 – 546,999,999 VND (or estimate around 11,800 – 23,800 USD), families with one child only, and formula feeding initiation at 1 – 2 months.ConclusionsThe prevalence of FGIDs in Vietnamese infants and young children is relatively low compared to the published literature using Rome IV diagnostic criteria. Infantile regurgitation was the most common FGID in Vietnamese infants while functional constipation was most prevalent among Vietnamese young children.Trial registrationNetherlands Trial Registry Identifier: NL7286/NTR7495.