FGID Application, Focused on Treatment of Infantile Colic
Hans Hoekstra
Jeroen Bosch Hospital, sHertogenbosch, The Netherland
Infantile colic is a common and distressful problem during infancy with effects on the infant, the parents and health-care professionals. It is mostly defined according Wessel’s rule of three or according to the Rome criteria, of which the latest revisions focus on the inconsolable character of crying rather than the amount of crying. Several pathophysiological theories, including neurodevelopmental, microbial, gastro-intestinal, nutritional, and psychosocial mechanisms, have been proposed to contribute to infantile colic. When no alarm signs or red flags are present, infantile colic should first be treated with reassurance and explanation for the parents. Parental support is one of the important cornerstones during this period.
For the evaluation of interventions in infantile colic a well-defined (core) outcome set is essential. At the present time there is no evidence for a positive role for medication other than the weak evidence for probiotic therapy. Probiotic therapy is strain-dependent, with the best evidence at this moment for L. reutri DSM 17938 in breast-fed infants. We urgently need well-performed randomized clinical trials in various populations in order to improve the current level of recommendations.
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