Functional constipation in infants and toddler: modern possibilities of using pro- and prebiotics
https://doi.org/10.51793/OS.2023.26.1.002
Abstract
One of the most common gastroenterological pathologies in childhood is constipation of functional origin. The frequency of constipation in children of the first year of life ranges from 10.7% to 17.6%. Constipation is considered as a rare, painful, difficult and/ or incomplete bowel movement with stools of varying degrees of density and diameter. When diagnosing constipation in young children, it is important to focus not only on the frequency of the stool, but also on its nature, using the Bristol stool consistency scale. Even with daily bowel movements, accompanied by painful sensations and dense feces, the condition must be regarded as constipation. Suggested triggers in the first year of life are most often related to dietary changes, previous intestinal infection, and the presence of anal fissures. After the first year, improper toilet training may be an additional factor. When toilet training is incorrect, children begin to retain feces, which leads to painful defecation, and further forms fear, leading to an even greater delay in defecation. For the prevention and correction of constipation in young children, the following points are important: the presence of support for the legs during defecation; Encouraging the child to consume more water, fruits and vegetables every day, as well as to get enough physical activity. In the diet therapy of functional constipation, the role of some probiotics (strains of Lactobacillus, Bifidobacterium lactis) and prebiotics (inulin, galacto- and fructooligosaccharides) has been proven.
About the Authors
S. B. Krutikhina
Federal State Autonomous Educational Institution of Higher Education Sechenov First Moscow State University of Medicine of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Svetlana B. Krutikhina, MD, Assistant of the Department of Children's Diseases at the Clinical Institute of Children's Health named after N. F. Filatov
8/2 Trubetskaya str., Moscow, 119991
N. A. Geppe
Federal State Autonomous Educational Institution of Higher Education Sechenov First Moscow State University of Medicine of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Nataliya A. Geppe, Dr. of Sci. (Med.), Professor, Head of the Department of Children's Diseases at the Clinical Institute of Children's Health named after N. F. Filatov
8/2 Trubetskaya str., Moscow, 119991
E. A. Yablokova
Federal State Autonomous Educational Institution of Higher Education Sechenov First Moscow State University of Medicine of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Ekaterina A. Yablokova, MD, Associate Professor of the Department of Children's Diseases at the Clinical Institute of Children's Health named after N. F. Filatov
8/2 Trubetskaya str., Moscow, 119991
M. A. Kudryashova
Federal State Autonomous Educational Institution of Higher Education Sechenov First Moscow State University of Medicine of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Mariya A. Kudryashova, MD, Assistant of the Department of Children's Diseases at the Clinical Institute of Children's Health named after N. F. Filatov
8/2 Trubetskaya str., Moscow, 119991
References
1. Vandenplas Y., Hauser B., Salvatore S. Functional Gastrointestinal Disorders in Infancy: Impact on the Health of the Infant and Family // Pediatr. Gastroenterol. Nutr. 2019; 22: 207.
2. Нofman D., Kudla U., Miqdady M., et al. Faecal Microbiota in Infants and Young Children with Functional Gastrointestinal Disorders: A Systematic Review // Nutrients. 2022; 14: 974. https://doi.org/10.3390/nu14050974.
3. Zeevenhooven J., Koppen I. J. N., Benninga M. A. The New Rome IV Criteria for Functional Gastrointestinal Disorders in Infants and Toddlers // Pediatr. Gastroenterol. Hepatol. Nutr. 2017; 20: 1-13.
4. Bel'mer S. V., Volynets G. V., Gorelov A. V., Gurova M. M., Zvyagin A. A., Korniyenko Ye. A., Novikova V. P., Pechkurov D. V., Privorotskiy V. F., Tyazheva A. A., Fayzullina R. A., Khavkin A. I., Erdes S. I. Functional disorders of the digestive system in children. Recommendations of the Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists. Part 1 // Ros. vestn. perinatol. i pediatr. 2020; 65 (4): 150-161. DOI: 10.21508/1027-4065-2020-65-4-150-161.
5. Pakhomovskaya N. L., Tatianina O. F., Lazareva T. Yu. Functional constipation in children // Meditsinskiy Sovet. 2022; 16 (1): 106–113. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-1-106-113.
6. Turco R., Miele E., Russo M., et al. Early-life factors associated with pediatric functional constipation // J Pediatr Gastroenterol Nutr. 2014; 58 (3): 307-312.
7. Advantages of adapted goat milk-based formulas for functional disorders of the gastrointestinal tract in young children with artificial feeding Geppe N. A., Meleshkina A. V., Yablokova E. A., Chebysheva S. N. // Lechaschi Vrach. 2020; 3: 43-49. DOI: 10.26295/OS.2020.72.94.007.
8. Walter A. W., Hovenkamp A., Devanarayana N. M., et al. Functional constipation in infancy and early childhood: epidemiology, risk factors, and healthcare consultation // BMC Pediatr. 2019; 19: 285. https://doi.org/10.1186/s12887-019-1652-y.
9. Miceli Sopo S., Arena R., Greco M., Bergamini M., Monaco S. Constipation and cow's milk allergy: a review of the literature // Int Arch Allergy Immunol. 2014; 164 (1): 40-45.
10. Rajindrajith S., Devanarayana N. M., Lakmini C., et al. Association between child maltreatment and constipation: a school-based survey using rome III criteria // J Pediatr Gastroenterol Nutr. 2014; 58 (4): 486-490.
11. Benninga M. A., Nurko S., Faure C., St James Roberts I., Schechter N. L., Nurko S. Childhood Functional Gastrointestinal Disorders: Neonate/ Toddler // Gastroenterology. 2016;S0016-5085(16)00182-7. https://doi.org/10.1053/j.gastro.2016.02.016.
12. Jeremy Meng Dao Hо, Choon How How. Chronic constipation in infants and children // Singapore Med J. 2020; 61 (2): 63-68 DOI: https://doi.org/10.11622/smedj.2020014.
13. Banaszkiewicz A., Szajewska H. Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constiopation in children: A doubleblind placebo-controlled randomized trial // J. Pediatr. 2005; 146: 364-396.
14. Bu L. N., Chang M. H., Ni Y. H., et al. Lactobacillus casei rhamnosus Lcr 35 in children with chronic constipation // Pediatr. Int. 2007; 49: 485-490.
15. Wojtyniak K., Horvath A., Dziechciarz P., Szajewska H. Lactobacillus casei rhamnosus Lcr35 in the management of functional constipation in children: A randomized trial // J. Pediatr. 2017; 184: 101-105.
16. Wegner A., Banaszkiewicz A., Kierkus J., et al. The effectiveness of Lactobacillus reuteri DSM 17938 as an adjunct to macrogol in the treatment of functional constipation in children // Clin. Res. Hepatol. Gastroenterol. 2018; 42: 494-500.
17. Coccorullo P., Strisciuglio C., Martinelli M., et al. Lactobacillus reuteri (17938) in infants with functional chronic constipation: A double-blind, randomized, placebo-controlled study // J. Pediatr. 2010; 157: 598-602.
18. Guerra P. V. P., Lima L. N., Souza T. C., et al. Periatric functional constipation treatment with Bifidobacterium-containing yogurt: A crossover, double-blind, controlled trial // World J. Gastroenterol. 2011; 17: 3916-3921.
19. Tabbers M. M., Chmielewska A., Roseboom M. G., et al. Fermented milk containing Bifidobacterium lactis DN-173 010 in childhood constipation: A randomized, double-blind, controlled trial // Pediatrics. 2011; 127: 1392-1399.
20. Sadeghzadeh M., Rabieefar A., Khoshnevisasl P., et al. The effect of probiotics on childhood constipation: A randomized controlled double blind clinical trial // Int. J. Pediatr. 2014; 2014: 937212.
21. Russo M., Giugliano F. P., Quitadamo P., et al. Efficacy of a mixture of probiotic agents as complimentary therapy for chronic functional constipation in childhood // Ital. J. Pediatr. 2017; 43: 24.
22. Costalos C., Kapiki A., Apostolou M., Papathoma E. The effect of a prebiotic supplemented formula on growth and stool microbiology of term infants // Early Hum. Dev. 2008; 84: 45-49.
23. Bisceglia M., Indrio F., Riezzo G., et al. The effect of prebiotics in the management of neonatal hyperbilirubinaemia // Acta Paediatr. 2009; 98: 1579-1581.
24. Veereman-Wauters G., Staelens S., Van de Broek H., et al. Physiological and bifidogenic effects of prebiotic supplements in infant formulae // J. Pediatr. Gastroenterol. Nutr. 2011; 52: 763-771.
25. Souza D. D. S., Tahan S., Weber T. K., et al. Randomized, Double-Blind, Placebo-Controlled Parallel Clinical Trial Assessing the Effect of Fructooligosaccharides in Infants with Constipation // Nutrients. 2018; 10: 1602. https://doi.org/10.3390/nu10111602.
26. García Contreras A. A., Vásquez Garibay E. M., Sánchez Ramírez C. A., et al. Lactobacillus reuteri DSM 17938 and Agave Inulin in Children with Cerebral Palsy and Chronic Constipation: A Double-Blind Randomized Placebo Controlled Clinical Trial // Nutrients. 2020; 12: 2971. https://doi.org/10.3390/nu12102971.
27. Benninga M. A. MENA Infant Constipation Study Group; Vandenplas Y. Magnesium-rich formula for functional constipation in infants: A randomized comparator-controlled study // Pediatr. Gastroenterol. Nutr. 2019; 22: 270-281.
28. Krutikhina S. B., Yablokova E. A., Galstyan L. A., Gorelov A. V. The role of prebiotics in the formation of the microbiome in children of the first year of life // Farmateka. 2022; 2 (29): 38-41. (In Russ.). DOI: 10.18565/pharmateca.2022.2.38-41.
Review
For citations:
Krutikhina S.B., Geppe N.A., Yablokova E.A., Kudryashova M.A. Functional constipation in infants and toddler: modern possibilities of using pro- and prebiotics. Lechaschi Vrach. 2023;(1):11-14. (In Russ.) https://doi.org/10.51793/OS.2023.26.1.002
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