Management of the Most Common Functional Gastrointestinal Disorders in Infancy: The Middle East Expert Consensus / 대한소아소화기영양학회지

The occurrence of functional gastrointestinal disorders (FGIDs) is a formidable challenge for infants, parents, and healthcare professionals. Although data from the Middle East are scarce, experts consider FGIDs a prevalent condition in everyday clinical practice. The new Rome IV criteria revisited the definitions from a clinical perspective to provide a practical and consistent diagnostic protocol for FGIDs. However, the treatment practices for functional disorders vary considerably among Middle Eastern countries, often resulting in mismanagement with unnecessary investigations and treatments. In addition, the role of various treatment modalities, including probiotics such as Lactobacillus reuteri DSM 17938, in FGIDs requires further discussion and evaluation. During a consensus meeting, a locally relevant approach for treating common FGIDs such as infant regurgitation, infant colic, and functional constipation was discussed and approved by regional experts. The participants suggested a simplified treatment plan and protocol for general pediatricians and other primary care physicians managing FGIDs.This easy-to-follow standardized protocol will help streamline the initial management of this complex disorder in the Middle East region and even globally.

Management of the Most Common Functional Gastrointestinal Disorders in Infancy: The Middle East Expert Consensus / 대한소아소화기영양학회지

The occurrence of functional gastrointestinal disorders (FGIDs) is a formidable challenge for infants, parents, and healthcare professionals. Although data from the Middle East are scarce, experts consider FGIDs a prevalent condition in everyday clinical practice. The new Rome IV criteria revisited the definitions from a clinical perspective to provide a practical and consistent diagnostic protocol for FGIDs. However, the treatment practices for functional disorders vary considerably among Middle Eastern countries, often resulting in mismanagement with unnecessary investigations and treatments. In addition, the role of various treatment modalities, including probiotics such as Lactobacillus reuteri DSM 17938, in FGIDs requires further discussion and evaluation. During a consensus meeting, a locally relevant approach for treating common FGIDs such as infant regurgitation, infant colic, and functional constipation was discussed and approved by regional experts. The participants suggested a simplified treatment plan and protocol for general pediatricians and other primary care physicians managing FGIDs.This easy-to-follow standardized protocol will help streamline the initial management of this complex disorder in the Middle East region and even globally.

Correction: Middle East Consensus Statement on the Diagnosis and Management of Functional Gastrointestinal Disorders in <12 Months Old Infants / 대한소아소화기영양학회지

The authors wish to make the following corrections to Table 4 and Fig. 3.

Middle East Consensus Statement on the Diagnosis and Management of Functional Gastrointestinal Disorders in <12 Months Old Infants / 대한소아소화기영양학회지

This paper covers algorithms for the management of regurgitation, constipation and infantile colic in infants. Anti-regurgitation formula may be considered in infants with troublesome regurgitation, while diagnostic investigations or drug therapy are not indicated in the absence of warning signs. Although probiotics have shown some positive evidence for the management of functional gastrointestinal disorders (FGIDs), the evidence is not strong enough to make a recommendation. A partially hydrolyzed infant formula with prebiotics and β-palmitate may be considered as a dietary intervention for functional constipation in formula fed infants. Lactulose has been shown to be effective and safe in infants younger than 6 months that are constipated. Macrogol (polyethylene glycol, PEG) is not approved for use in infants less than 6 months of age. However, PEG is preferred over lactulose in infants >6 months of age. Limited data suggests that infant formula with a partial hydrolysate, galacto-oligosaccharides/fructo-oligosaccharides, added β-palmitate may be of benefit in reducing infantile colic in formula fed infants in cases where cow's milk protein allergy (CMPA) is not suspected. Evidence suggests that the use of extensively hydrolyzed infant formula for a formula-fed baby and a cow's milk free diet for a breastfeeding mother may be beneficial to decrease infantile colic if CMPA is suspected. None of the FGIDs is a reason to stop breastfeeding.

Pratique de l'allaitement maternel dans une region de Beyrouth

The practice of breast feeding was reviewed in an inquiry carried on by the nursing students in Beirut and suburbs. 170 mothers answered the questionary concerning their experience in feeding their 170 babies as well as their previous 263 children of whom 249 were breast fed. 31.17% of these mothers were breast-feeding for the first time. 11% of the newborns were fed in the first hour of life. 29% of the newborns received breast milk as the first food. Breast milk remained exclusive for the first month of life in 37.54% of these newborns. Breast feeding mothers changed their feeding habit in half of the cases. They increased the quantity but the quality of nutriments was still deficient. This misunderstanding of breast-feeding is due primarily to the insufficiently informed mothers and to the inadequate habits of nursery. It is important to ameliorate the quality of information for the breast feeding mothers and their household for the success of any policy encouraging breast feeding in Lebanon