Chapter 34: Functional Gastrointestinal Disorders in infants and toddlers

Silvia Salvatore, Yvan Vandenplas

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Abstract

Functional gastrointestinal disorders (FGIDs) are frequently reported in infants and toddlers. Rome IV criteria define seven different FGIDs: infantile colic, regurgitation, and functional constipation represent the most common disorders, while infant dyschezia, cyclic vomiting syndrome, rumination, and functional diarrhea are reported in less than 10% of subjects. Overall FGIDs affect over 50% of healthy infants all over the world and multiple disorders often coexist in the same individual. FGIDs are multifactorial conditions. Genetic, familiar, environmental, feeding, psychosocial, emotional variables, neonatal events, microbiota, motility, pain perception, and coping may all contribute to the occurrence and severity of FGIDs. Despite having a spontaneous resolution after a few months in the vast majority of infants and toddlers, these conditions, nevertheless, have relevant health, behavioral, and economic impact. Parental reassurance and education are the essential treatments of FGIDs both in infants and in children. Nutritional advice is often required particularly for formula-fed infants. Investigations and test are usually not necessary in the absence of alarm signs and symptoms suggestive of organic diseases. Pharmacological intervention should be limited to patients with persistent constipation. There is evidence that a specific strain of probiotic reduces the duration of daily crying in breast fed infants with colic. No significant benefit is currently reported for other strains of probiotics or for other FGIDs. Likewise, herbal products and complementary alternative medicine have not yet proven beneficial effects.

Keywords
Original languageEnglish
Title of host publicationPediatric Neurogastroenterology
EditorsC. Faure, C. Di Lorenzo, N. Thapar
PublisherSpringer International Publishing AG
Chapter34
Pages465-475
Number of pages11
Publication statusPublished - 1 Jan 2023

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