Long and short term symptoms

In the short-term, symptoms of FGIDs can lead to parental anxiety and stress, poor quality of life, shortened duration of full breastfeeding, numerous formula changes and medical consultations, loss of parental working days, and high associated healthcare costs.^4-8

In the longer-term, some FGIDs during infancy may predispose children to GI problems later in life.^1,9 For example, infants with frequent (>90 days) regurgitation or vomiting in the first 2 years of life may be more likely to have gastroesophageal reflux symptoms at 9 years of age.^1,9 Similarly, infants with colic may be more likely to develop functional GI problems later in life.¹ Colic during infancy has also been associated with behavioural problems throughout childhood, deficits in preschool adaptive behaviour and social skills, and eating problems.¹

Current treatment practices

Research suggests that prescribed medications and over-the-counter remedies are frequently used to manage the symptoms of FGIDs.^2,4,10 While there is some evidence to support pharmacological interventions for functional constipation, pharmacological therapy appears to offer no benefit for other FGIDs that occur in early life.^2-4

As such, infants suffering from FGIDs receive a large number of medical treatments that may be contraindicated or not substantiated scientifically.^2,11 There is broad consensus that there is no indication for pharmacological treatment (such as proton pump inhibitors) in infants with colic or regurgitation, with no evidence of effectiveness and significant risks or negative side effects.³

In treating digestive problems in infants, it is important to avoid the use of drugs and invasive procedures where possible. Nutritional treatments are generally the preferred option. — Vandenplas et al. 2015¹²

Guidelines and recommendations for management of FGIDs

First-line management of the most common FGIDs, particularly infantile colic and regurgitation, should focus on parental reassurance and nutritional advice.^1-4 The latter includes recommendations on feeding volume, frequency and techniques for all infants, and considering specialty formulas with proven effects for formula-fed infants with persisting symptoms.⁴ With the exception of functional constipation, drug treatment is seldom required.⁴

By simply providing parental reassurance and nutritional advice, pharmacists and general practitioners can make a difference for families suffering with infantile FGIDs, with the potential to alleviate costs from public healthcare systems whilst treating according to best-practice guidelines.