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Review
. 2021 Jul;24(4):325-336.
doi: 10.5223/pghn.2021.24.4.325. Epub 2021 Jul 5.

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

Flavia Indrio  1 , Axel Enninger  2 , Wajeeh Aldekhail  3 , Ghanem Al-Ghanem  4 , Abdulrahman Al-Hussaini  5 , Bakr Al-Hussaini  6 , Fawaz Al-Refaee  7 , Khoula Al-Said  8 , Bassam Eid  9 , Wafaa Faysal  10 , Ruwaida Hijazeen  11 , Hasan M A Isa  12 , Dinesh Onkarappa  13 , Mohammad Rawashdeh  14 , Pejman Rohani  15 , Maroun Sokhn  16
Affiliations
Review

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

Flavia Indrio et al. Pediatr Gastroenterol Hepatol Nutr. 2021 Jul.

Abstract

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.

Keywords: Colic; Constipation; Gastrointestinal diseases; Infant; Laryngopharyngeal reflux; Middle East; Probiotics.

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Conflict of interest statement

Conflict of Interest: Flavia Indrio serves as a Speaker for BioGaia, Nestlé Nutrition Institute and Danone. Axel Enninger serves as a speaker, member of advisory board Nestlé Nutrition Institute, Speaker, member of advisory board Milupa/Danone, Speaker: infectopharm, abbvie, Nutricia and Author: Thieme, infectopharm. None of the other authors have a conflict of interest.

Figures

Fig. 1
Fig. 1. (A) Management algorithm for infant regurgitation in breastfed infants. (B) Management algorithm for infant regurgitation in formula-fed infants.
GI: gastroenterology, BF: breastfeeding.
Fig. 2
Fig. 2. (A) Management algorithm for infant colic in breastfed infants. (B) Management algorithm for infant colic in formula-fed infants.
GI: gastroenterology.
See this image and copyright information in PMC

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