Functional Gastrointestinal Disorders Common for Infants in Brazil

New research show functional gastrointestinal disorders (FGIDs) were very prevalent for infants in Brazil.

A team, led by Mauro Batista de Morais, MD, PhD, Division of Pediatric Gastroenterology, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, assessed the prevalence of the most frequent functional gastrointestinal disorders in infants from Brazil seen at private pediatric clinics and their relationship with cesarean delivery, breastfeeding, and history of prematurity.

The Study

In the cross-sectional study, the investigators examined 5080 infants under 12 months with routine visits in private pediatric clinics in Brazil.

Each mother of the infant answered questions on the type of delivery, type of feeding (breast milk, infant formula, cow milk, mixed feeding), history of prematurity, and gastrointestinal symptoms, with the investigators using the Rome IV criteria to diagnose FGIDs in the infant patients.

Associations

The results show infant regurgitation was found in 10.7% (n = 487), infant colic was found in 6.1% (n = 131), infant dysphasia was found in 4.0% (n = 157), functional constipation was found in 7.6% (n = 341), and functional diarrhea was found in 0.09% (n = 2) of the participants.

Prematurity was also linked to infant regurgitation (OR, 1.41; 95% CI, 1.05-1.90), infant colic (OR, 1.97; 95% CI, 1.19-3.24), infant dysphasia (OR, 1.64, 95% CI, 1.02-2.64), and functional constipation (OR, 1.44; 95% CI, 1.02-2.02) (all P <0.05).

Prematurity was also associated with 2 or more FGIDs between 21-150 days of age (OR, 3.06; 95% CI, 1.74-5.37) (P <0.001).

“FGIDs are common in infants seen in the private pediatric practice in Brazil,” the authors wrote. “History of prematurity was associated with infant regurgitation, infant colic, functional dysphasia, and functional constipation.”

The Link to Antibiotics

Earlier this year, investigators found antibiotic use within the first week of life does result in a risk of developing abdominal pain 4-6 years later.

Antibiotic use could lead to the development of various functional gastrointestinal disorders.

In the prospective, observational cohort, the investigators examined 436 term-born infants through age 4-6. Of this group, 151 received broad-spectrum antibiotics and 285 were healthy controls.

The presence of functional abdominal pain was significantly higher in the antibiotic cohort than it was in the control group (4% vs. 0.4% respectively; P = 0.045) and children with food allergy fulfilled significantly more often the criteria for irritable bowel syndrome (IBS) and abdominal migraine (26% vs. 9%; P = 0.002 and 7% vs. 1%; P = 0.043 respectively) compared to pediatric patients without allergies.

However, there were no differences in functional gastrointestinal disorders at age 4-6 years between participants with or without a history of infantile colic, but there were significant differences found in gut-associated immune markers between pediatric patients with and without functional gastrointestinal disorders.

The study, “Prevalence of functional gastrointestinal disorders in Brazilian infants seen in private pediatric practices and their associated factors,” was published online in the Journal of Pediatric Gastroenterology and Nutrition.