Early life events predispose the onset of childhood functional gastrointestinal disorders

Bonilla, Silvana; Saps, Miguel

doi:10.1016/j.rgmx.2013.02.001

Cited by 36 publications

(35 citation statements)

References 77 publications

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“…It has been reported that at least one of two infants display one or more FGIDs, such as functional constipation or infantile colic, or related signs and symptoms such as hard stools or excessive crying . Even though FGIDs are mostly seen as benign in nature, and usually resolve over time, these may constitute early traumatic events that cause appreciable distress to infants and parents, with pending long‐term consequences for the well‐being of both . Considering the high incidence and impact of early‐life FGIDs, their prevention would be preferable to their treatment, with the implication that nutritional solutions would be preferable to pharmacological interventions.…”

Section: Discussionmentioning

confidence: 99%

Randomised controlled trial demonstrates that fermented infant formula with short‐chain galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides reduces the incidence of infantile colic

et al. 2017

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AimWe examined the effects on gastrointestinal (GI) tolerance of a novel infant formula that combined specific fermented formula (FERM) with short‐chain galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides (scGOS/lcFOS), with a 9:1 ratio and concentration of 0.8 g/100 mL.MethodsThis prospective, double‐blind, randomised, controlled trial comprised 432 healthy, term infants aged 0–28 days whose parents decided to not start, or discontinued, breastfeeding. Infant formula with scGOS/lcFOS+50%FERM, scGOS/lcFOS+15%FERM, 50%FERM and scGOS/lcFOS were tested. Parents completed standardised seven‐day diaries on GI symptoms, crying, sleeping and stool characteristics each month until the infants were 17 weeks.ResultsAll the formulas were well tolerated. At four weeks, the overall incidence of infantile colic was significantly lower (8%) with scGOS/lcFOS+50%FERM than scGOS/lcFOS (20%, p = 0.034) or 50%FERM (20%, p = 0.036). Longitudinal modelling showed that scGOS/lcFOS+50%FERM‐fed infants also displayed a persistently lower daily crying duration and showed a consistent stool‐softening effect than infants who received formula without scGOS/lcFOS.ConclusionThe combination of fermented formula with scGOS/lcFOS was well tolerated and showed a lower overall crying time, a lower incidence of infantile colic and a stool‐softening effect in healthy term infants. These findings suggest for the first time that a specific infant formula has a preventive effect on infantile colic in formula‐fed infants.

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Section: Discussionmentioning

confidence: 99%

Randomised controlled trial demonstrates that fermented infant formula with short‐chain galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides reduces the incidence of infantile colic

et al. 2017

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“…Functional gastrointestinal disorders (FGID) are characterized by the presence of chronic or recurrent digestive symptoms without an underlying identifiable structural or biochemical abnormality . Bonilla & Saps reviewed the impact of early‐life events and the development of FGID and found that early gastrointestinal inflammation, including acute bacterial gastroenteritis and CMPA, increased the risk of developing FGID . The suggestion that early‐life CMPA increases the risk was based on 2 studies, one on children aged 10 years, with a history of CMPA diagnosed at less than 1 year of age.…”

Section: Functional Gastrointestinal Disordermentioning

confidence: 91%

“…92 Bonilla & Saps reviewed the impact of early-life events and the development of FGID and found that early gastrointestinal inflammation, including acute bacterial gastroenteritis and CMPA, increased the risk of developing FGID. 93,94 The suggestion that early-life CMPA increases the risk was based on 2 studies, one on children aged 10 years, with a history of CMPA diagnosed at less than 1 year of age. That study found that 45% of children (n = 56) had gastrointestinal symptoms when using milk and milk products freely.…”

Section: Fun C Tional G a S Trointe S Tinal Disordermentioning

confidence: 99%

Non‐IgE‐mediated gastrointestinal allergies—Do they have a place in a new model of the Allergic March

Fox

Lozinsky

Michaelis

et al. 2019

Pediatric Allergy Immunology

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The rise in food allergy has been described as the “second wave” of the allergy epidemic, with some developed countries reporting a prevalence of 10% of challenge‐proven food allergies. Recognition of the Allergic March has played a crucial role in identifying causality in allergic conditions, linking atopic dermatitis to food allergy and food allergy to other atopic disorders, thereby highlighting opportunities in prevention and the importance of early intervention. This publication will establish the value of weaving the less well‐understood, non‐IgE‐mediated food allergy into the Allergic March and mapping its progression through childhood and its associated co‐morbidities. The proposed non‐IgE‐mediated Allergic March highlights the concomitant presentation of gastrointestinal symptoms and atopic dermatitis as early presenting symptoms in confirmed non‐IgE‐mediated allergies and the later development of atopic co‐morbidities, including asthma and allergic rhinitis, similar to the IgE‐mediated Allergic March. This publication highlights recent observations of a link between non‐IgE‐mediated food allergy in early childhood and functional gastrointestinal disorders in later life and also the reported occurrence of extra‐intestinal manifestations at later ages. Although significant limitations exist in regard to the proposed evolution of the Allergic March model, the authors hope that this publication will influence the management of non‐IgE‐mediated gastrointestinal allergies and inform future research and interventions.

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“…proposed that various mechanisms such as genetics, early life events, environmental, gastrointestinal and psychosocial factors act together in a complex interplay ultimately resulting in an alteration to the gut-brain axis 10,11,12,13,14,15,16 . Afferent signals from the gastrointestinal tract transmitted via the pain pathways are subsequently amplified and the patient's perception of painful stimuli is in turn enhanced 17 .…”

Section: Pathophysiologymentioning

confidence: 99%

Gastrointestinal and nutritional problems in neurologically impaired children

Quitadamo

Thapar

Staiano

et al. 2016

European Journal of Paediatric Neurology

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Fax: + 44 20 7813 8382Gut Motility disorders comprise a heterogeneous group of disorders that result from disruption of the functional integrity of the intrinsic neuromusculature of the gastrointestinal (GI) tract. This intrinsic neuromusculature includes the smooth muscle layers, the intrinsic nervous system of the GI tract (enteric nervous system or ENS) and the interstitial cells of Cajal. The contribution of each of these components to function can be compromised by alterations in structure (ranging from absence to derangement in numbers and/or anatomy) or of function (complete or partial failure in physiological function). This pathology can be primary or secondary to a number of insults e.g. infections, inflammation, toxins etc. In children disorders may be congenital being present from birth or acquired later in life. Finally involvement of the enteric neuromusculature can be patchy/segmental or affect the gastrointestinal tract diffusely.Neuro-gastroenterology is the study of the interface of all aspects of the gastrointestinal tract or digestive system with the different branches of the body's nervous system including the enteric, central and autonomic nervous systems. The combined terms 'Neurogastroenterology and motility' are designed to encompass the study of all the components of the enteric neuromuscualture and their modulating influences and represents one of the fastest growing areas in gastroenterology clinical practice and research. This chapter aims to address some of the most common neurogastroenterology and motility conditions seen in clinical practice ranging from those with defined pathology to those which fall under the umbrella of functional gastrointestinal disorders. The latter comprise some of the commonest but challenging disorders and the term 'functional' reflects the fact that in the majority of such conditions no organic cause can be found. It should also be noted that at the present time many functional disorders e.g. abdominal pain-related functional GI disorders, represent symptom complexes that can further be subdivided into more discrete entities e.g. irritable bowel syndrome, functional abdominal pain etc depending on the nature, location and associations of the symptoms. Clinicians will often rely on the presence or absence of 'red flags' e.g. associated weight loss, severe or significant symptoms etc to decide whether patients are likely to have organic or functional disorders. Exhaustive investigations in the latter are likely to prove fruitless, expensive and perpetuate 'illness behaviours' in the patients. Abdominal pain-related functional gastrointestinal disorders IntroductionAbdominal pain-related functional gastrointestinal disorders (FGID) constitute a spectrum of conditions characterised by the presence of recurrent abdominal pain in the absence of any defined pathology 1 . In the past these disorders fell under the single term 'Recurrent abdominal pain' (RAP) but have since been recategorised under an international initiative (Rome Foundation) to improve the dia...

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Early life events predispose the onset of childhood functional gastrointestinal disorders

Abstract: Early events may play an important role in the complex pathogenesis of functional gastrointestinal conditions. Timely intervention may have a critical impact on the prevention of this group of chronic incapacitating conditions.

Cited by 36 publications

References 77 publications

Randomised controlled trial demonstrates that fermented infant formula with short‐chain galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides reduces the incidence of infantile colic

Randomised controlled trial demonstrates that fermented infant formula with short‐chain galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides reduces the incidence of infantile colic

Non‐IgE‐mediated gastrointestinal allergies—Do they have a place in a new model of the Allergic March

Gastrointestinal and nutritional problems in neurologically impaired children

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