Colic and Other Functional Disorders in the First Year of Life
Presented by Marc Benninga, MD
Presentation Overview
Colic and Other Functional Disorders in the First Year of Life
M.A. Benninga, pediatric gastroenterologist, m.a.benninga@amsterdamumc.n
Emma Children’s Hospital, Amsterdam Universities Medical Center,
Amsterdam, The Netherlands,
Functional gastrointestinal disorders (FGIDs), such as colic, regurgitation, diarrhea and constipation are common worldwide and cover a wide range of disorders attributable to the gastrointestinal tract that cannot be explained by structural or biochemical abnormalities. The diagnosis of these disorders relies on symptom-based criteria, the so-called Rome criteria. In 2016 the Rome criteria were revised for infants/toddlers and for children and adolescents.
Reported prevalence rates of FGIDs in infants and toddlers vary between 27.1% and 38.0%, with the most prevalent disorders being infant regurgitation and functional constipation. Infants and toddlers with an FGID display a reduced quality of life and visit medical professionals more often compared to healthy controls. In addition, the impact on the families of affected children is considerable. Recurrent unexplained symptoms in young children can cause concerns for caretakers, especially because young children are unable to adequately describe emotions or pain. Whether these parental concerns result in health care utilization or not depends on the coping style of parents, their perception of their child’s symptoms and previous experiences they have had. During a consultation, clinicians should realize that these parental factors are as important as the child’s symptoms. Especially because the diagnosis of an FGID mainly relies on parental reports and interpretations of their child’s symptoms. This makes the diagnostic process challenging and underlines the importance of strict criteria for FGIDs in this age group.
In Rome IV, the diagnostic criteria for FGIDs in infants and toddlers have been refined. These revisions are expected to improve clinical care in infants and toddlers with FGIDs. Adequate diagnoses will enable choosing the appropriate treatment, which is expected to result in an improvement in the clinical outcomes of these patients. Furthermore, these internationally accepted criteria should be adhered to in future medical research, to establish homogeneity in study design, which enables comparison of study results.
About Dr. Benninga
Professor Marc Benninga studied medicine at the University of Amsterdam, the Netherlands. After receiving his Medical degree he worked as a research fellow at the department of paediatric gastroenterology and nutrition at the Academic Medical Centre in Amsterdam with Jan Taminiau and Hans Büller. He performed extensive research on constipation and faecal incontinence in childhood.
Subsequently he was trained in paediatrics at the Wilhelmina Children’s Hospital in Utrecht, The Netherlands. After his paediatric training he performed research at The Women’s and Children’s Hospital, Adelaide, Australia with Geoff Davidson and Taher Omari. During his stay in Adelaide his research focussed on maturation of upper gastrointestinal motility in very young infants. In 1999 he became a staff member in the Academic Medical Centre in Amsterdam and currently he is the head of the department paediatric gastroenterology & Nutrition.
The focus of his current clinical and research work is gastro-oesophageal reflux disease, recurrent abdominal pain, constipation, functional non-retentive faecal incontinence and inflammatory bowel disease in childhood.
He played in the Dutch National hockey team and competed at the Olympics in 1988, Seoul.