Exploring hypotheses and rationale for causes of infantile colic

Abstract

Background Infantile colic is a frequent problem in neonates and infants. This review addresses current management including the results for nutrient modifications, soy-based formulas, and prebiotics, probiotics and synbiotics. Purpose Given the evidence that there is still an unmet clinical need, as current treatments are incompletely efficacious, we have examined the evidence around three hypothetical mechanisms that could potentially be involved in etiopathogenesis of infantile colic: immaturity of bile acid mechanisms that alter intraluminal and absorptive mechanisms, immaturity in motility and alterations in the microbiome. Understanding these potential mechanisms may lead to the introduction of diagnostic procedures that should enhance the selection or individualization of therapy for infantile colic.

To learn, to remember, to forget—How smart is the gut?

“…This would be indicative of a stored response pattern based on long‐term neural plasticity. In this respect, it may also be asked whether the very early‐life experience of infant colic when the immune system and the ESN first learn to handle foreign antigens, predisposes the gut to respond stronger to gastrointestinal infections later in life, and finally determines the occurrence of IBS.…”

New looking to the old problem: Infantile Colic

“…Bu değişiklikler sonucu ortaya çıkan azalmış kolonkontraktilitesinin koliğe yolaçabileceği ileri sürül-müştür (26) .…”

Gut Microbiota Dysbiosis and Role of Probiotics in Infant Colic

“…Alterations in gut microbiota of colicky infants are summarized in Table 2. Importantly, some factors related to the intestinal microbiota are age-related, which could help explain why infant colic resolves spontaneously around 4 to 6 months of age [2]: First, bile acids represent a key environmental factor modulating gut bacteria at high taxonomic levels, and overall bile acid metabolism is altered during the first months of life (as demonstrated by the fact that cholic to chenodeoxycholic acids ratio in duodenum and bile acid levels in serum are increased during the first months of life). Second, the overall diversity of the intestinal microbiome has been described to increase in an age-related manner during the first months of life, and increased diversity is known to make ecosystems more resistant to perturbations by opportunistic organisms (such as Enterobacteria in the gut).…”

“…A variety of causes for infant colic have been suggested, including abnormal gastrointestinal function, immaturity of the gut, spastic colon, accumulation of gas, allergic problems and lack of sufficient parent-to-child interaction (Table 1) [2,6,10]. Despite this unclear and possibly multifactorial etiology, studies by independent research groups have correlated alterations in gut microflora with infant colic [11][12][13][14][15][16].…”

“…The crying bouts occur without obvious cause, so that their unexplained nature is one of the main reasons for caregivers' concerns [1]. Its etiology is unknown and possibly multifactorial [2]. Because it affects otherwise healthy infants without a specific cause, infant colic has a controverted physiopathology.…”