scholarly journals Gluten and Functional Abdominal Pain Disorders in Children

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1491 ◽  
Author(s):  
Alejandro Llanos-Chea ◽  
Alessio Fasano
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Functional Abdominal Pain ◽  
Adults And Children ◽  
Small Intestinal ◽  
Irritable Bowel

In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders.

scholarly journals FRUCTOSE MALABSORPTION IN CHILDREN WITH FUNCTIONAL DIGESTIVE DISORDERS

2013 ◽  
Vol 50 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Adriana Chebar LOZINSKY ◽  
Cristiane BOE ◽  
Ricardo PALMERO ◽  
Ulysses FAGUNDES-NETO
Keyword(s):  
Aqueous Solution ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Breath Test ◽  
Gastrointestinal Symptoms ◽  
Functional Abdominal Pain ◽  
Hydrogen Breath Test ◽  
Fasting Level ◽  
Fructose Malabsorption ◽  
Irritable Bowel

Context Fructose is a monosaccharide frequently present in natural and artificial juice fruits. When the concentration of fructose in certain food is present in excess of glucose concentration some individuals may develop fructose malabsorption. Objectives To report the frequency of fructose malabsorption utilizing the hydrogen breath test in children with gastrointestinal and/or nutritional disorders. Methods Between July 2011 and July 2012, 43 patients with gastrointestinal and/or nutritional disorders, from both sexes, were consecutively studied, utilizing the hydrogen breath test with loads of the following carbohydrates: lactose, glucose, fructose and lactulose. Fructose was offered in a 10% aqueous solution in the dose of 1 g/kg body weight. Samples were collected fasting and at every 15 minutes after the intake of the aqueous solution for a 2 hour period. Malabsorption was considered when there was an increase of >20 ppm of hydrogen over the fasting level, and intolerance was diagnosed if gastrointestinal symptoms would appear. Results The age of the patients varied from 3 months to 16 years, 24 were boys. The following diagnosis were established: irritable bowel syndrome with diarrhea in 16, functional abdominal pain in 8, short stature in 10, lactose intolerance in 3, celiac disease in 1, food allergy in 1 and giardiasis in 1 patient. Fructose malabsorption was characterized in 13 (30.2%) patients, and intolerance in 1 (2.3%) patient. The most frequent fructose malabsorption was characterized in 7 (16.3%) patients with irritable bowel syndrome and in 4 (9.3%) patients with functional abdominal pain. Conclusions Patients with irritable bowel syndrome and functional abdominal pain were the main cause of fructose malabsorption.

scholarly journals Effect of a Symbiotic Mixture on Fecal Microbiota in Pediatric Patients Suffering of Functional Abdominal Pain Disorders

Processes ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 2157
Author(s):  
Cristina Adriana Becheanu ◽  
Roxana Elena Smădeanu ◽  
Iulia Florentina Ţincu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Wide Spectrum ◽  
Adult Population ◽  
Symptom Relief ◽  
Bifidobacterium Longum ◽  
Gastrointestinal Symptoms ◽  
Fecal Microbiota ◽  
Functional Abdominal Pain ◽  
Irritable Bowel

(1) Background: Functional abdominal pain disorders (FAPDs) represent one of the main etiologies of chronic abdominal pain in the pediatric population. A wide spectrum of probiotic or prebiotic mixtures has been evaluated in trials regarding benefits in patients with FAPDs, mainly in the adult population. (2) Methods: This study was interested in evaluating the effect of oral supplementation with a symbiotic mixture on intestinal microbiota in children with functional dyspepsia (FD), irritable bowel syndrome with diarrhea (IBS-D), and irritable bowel syndrome with constipation (IBS-C). A combination of six bacterial strains (Lactobacillus rhamnosus R0011, Lactibacillus casei R0215, Bifidobacterium lactis BI-04, Lactobacillus acidophilus La-14, Bifidobacterium longum BB536, Lactobacillus plantarum R1012) and 210 mg of fructo-oligosaccharides-inulin were administered orally, daily, for 12 weeks and patients were scored for severity of symptoms and fecal microbiota before and after the treatment. (3) Results: The proportion of patients with adequate symptom relief was higher in the IBS-D than in the IBS-C group; however, the difference was not statistically significant (74.4% vs. 61.9%, p = 0.230). There was an increasing proportion of bacterial genera associated with health benefits, for both IBS-C and IBS-D (IBS-C: 31.1 ± 16.7% vs. 47.7 ± 13.5%, p = 0.01; IBS-D: 35.8 ± 16.2% vs. 44.1 ± 15.1%, p = 0.01). (4) Conclusions: Administration of a symbiotic preparation resulted in significant changes to the microbiota and gastrointestinal symptoms in patients with FAPDs.

scholarly journals Evaluating the effects of probiotics in pediatrics with recurrent abdominal pain

2020 ◽  
Vol 63 (12) ◽  
pp. 485-490 ◽  
Author(s):  
Parisa Rahmani ◽  
Azin Ghouran-orimi ◽  
Farzaneh Motamed ◽  
Alireza Moradzadeh
Keyword(s):  
Abdominal Pain ◽  
Lactobacillus Reuteri ◽  
Functional Gastrointestinal Disorders ◽  
Recurrent Abdominal Pain ◽  
Placebo Treatment ◽  
Functional Abdominal Pain ◽  
Double Blind ◽  
Probiotic Treatment ◽  
Rome Iii ◽  
Irritable Bowel

Background: Recurrent abdominal pain (RAP) is one of the frequent complaints in general practice, particularly in pediatrics and is among the common cause of referral to gastroenterology clinics.Purpose: This study is designed to investigate the effects of probiotics for the treatment of RAP and desired therapeutic outcomes.Methods: One hundred twenty-five children with the diagnosis of RAP according to Rome III criteria for irritable bowel syndrome (IBS), functional abdominal pain (FAP), functional dyspepsia (FD), and abdominal migraine (AM), were enrolled in this double-blind randomized controlled trial.Results: Sixty-five subjects received probiotics, and others received placebo treatment for 4 weeks. <i>Lactobacillus reuteri</i> was therapeutically effective in 32 patients compared to 8 patients, responding to the placebo treatment. Compared to baseline, all pain-related variables showed a significant reduction for the IBS and FD at the end of the 4th week. However, it did not respond well in FAP and AM groups. Pain-related outcomes such as, frequency of the pain, severity, and duration of the pain were decreased following the probiotic treatment. No therapeutic response was seen in AM group after the administration of probiotics. <i>L. reuteri</i> significantly led to pain relief in the overall population, and also in FAP, FD, and IBS subgroups.Conclusion: <i>L. reuteri</i> probiotics are likely to lead to RAP relief and can be recommended for the treatment of functional gastrointestinal disorders.

scholarly journals Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3735
Author(s):  
Maria Raffaella Barbaro ◽  
Cesare Cremon ◽  
Diana Wrona ◽  
Daniele Fuschi ◽  
Giovanni Marasco ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Functional Gastrointestinal Disorders ◽  
Self Report ◽  
Western World ◽  
Gastrointestinal Disorders ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Double Blind ◽  
Irritable Bowel

Gluten-free diets are increasingly chosen in the Western world, even in the absence of a diagnosis of celiac disease. Around 10% of people worldwide self-report gluten-related complaints, including intestinal and extra-intestinal symptoms. In most cases, these subjects would be labeled as patients suffering from irritable bowel syndrome (IBS) who place themselves on a gluten-free diet even in the absence of celiac disease. In some instances, patients report a clear benefit by avoiding gluten from their diet and/or symptom worsening upon gluten reintroduction. This clinical entity has been termed non-celiac gluten sensitivity (NCGS). The symptoms referred by these patients are both intestinal and extra-intestinal, suggesting that similarly to functional gastrointestinal disorders, NCGS is a disorder of gut–brain interaction. It remains unclear if gluten is the only wheat component involved in NCGS. The mechanisms underlying symptom generation in NCGS remain to be fully clarified, although in the past few years, the research has significantly moved forward with new data linking NCGS to changes in gut motility, permeability and innate immunity. The diagnosis is largely based on the self-reported reaction to gluten by the patient, as there are no available biomarkers, and confirmatory double-blind challenge protocols are unfeasible in daily clinical practice. Some studies suggest that a small proportion of patients with IBS have an intolerance to gluten. However, the benefits of gluten-free or low-gluten diets in non-celiac disease-related conditions are limited, and the long-term consequences of this practice may include nutritional and gut microbiota unbalance. Here, we summarize the role of gluten in the clinical features, pathophysiology, and management of NCGS and disorders of gut–brain interaction.

scholarly journals Probiotics on Pediatric Functional Gastrointestinal Disorders

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1836 ◽  
Author(s):  
Anna Pärtty ◽  
Samuli Rautava ◽  
Marko Kalliomäki
Keyword(s):  
Abdominal Pain ◽  
Lactobacillus Reuteri ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Current Evidence ◽  
Infantile Colic ◽  
Functional Abdominal Pain ◽  
Single Strain ◽  
Potential Association ◽  
Irritable Bowel

The potential association between gut microbiota perturbations and childhood functional gastrointestinal disturbances opens interesting therapeutic and preventive possibilities with probiotics. The aim of this review was to evaluate current evidence on the efficacy of probiotics for the management of pediatric functional abdominal pain disorders, functional constipation and infantile colic. Thus far, no single strain, combination of strains or synbiotics can be recommended for the management of irritable bowel syndrome, functional abdominal pain or functional constipation in children. However, Lactobacillus reuteri DSM 17938 may be considered for the management of breastfed colic infants, while data on other probiotic strains, probiotic mixtures or synbiotics are limited in infantile colic.

Other Dietary Confounders: FODMAPS et al.

2015 ◽  
Vol 33 (2) ◽  
pp. 269-276 ◽  
Author(s):  
Peter R. Gibson ◽  
Jane G. Muir ◽  
Evan D. Newnham
Keyword(s):  
Abdominal Pain ◽  
Wheat Germ Agglutinin ◽  
Wheat Germ ◽  
Gastrointestinal Symptoms ◽  
Western World ◽  
Clinical Effects ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Common Condition ◽  
Wheat Proteins

Background: While it is well documented and widely appreciated that ingestion of wheat (and less so rye and barley) is associated with gastrointestinal symptoms such as bloating or abdominal pain, the component of wheat to which such an effect is attributed is less well established. Key Messages: Wheat is a complex of proteins (80% gluten, 20% metabolic proteins), carbohydrates (starch, non-starch polysaccharides, fructans), lipids and other components. The majority of attention has focused on gluten as the culprit in triggering symptoms, but re-challenge studies have nearly all used wheat flour-related products (such as bread) as the stimulus. When carbohydrate-deplete gluten was used as the challenge agent, gluten-specific feelings of depression and not gut symptoms were observed in those who fulfilled strict criteria of ‘non-coeliac gluten sensitivity', thereby underlining the complexity of cereals and of undertaking research in this area. Candidate components other than gluten include poorly absorbed oligosaccharides (mainly fructans), non-gluten wheat proteins such as amylase-trypsin inhibitors or wheat germ agglutinin, and exorphins released during the digestion of gluten. Specific biological and/or clinical effects associated with gluten-free diets or wheat ingestion need to be carefully dissected before attribution to gluten can be claimed. Conclusions: Currently, coeliac disease is the only common condition that has been unequivocally linked to gluten. Inaccurate attribution will be associated with suboptimal therapeutic advice and at least partly underlies the current gluten-free epidemic gripping the Western world.

scholarly journals Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain

2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 39-46 ◽  
Author(s):  
Frank M. Ruemmele
Keyword(s):  
Abdominal Pain ◽  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Clear Cut ◽  
Clinical Presentations ◽  
New Findings ◽  
Three Phase ◽  
Gi Symptoms

Several disorders related to the ingestion of gluten are well recognized despite overlapping clinical presentations: celiac disease, an autoimmune enteropathy triggered by gluten ingestions in susceptible individuals, allergy to wheat, and more recently non-celiac gluten sensitivity (NCGS). While celiac disease and wheat allergy are well-known disorders with a clear-cut diagnosis based on clinical tests and biological parameters, NCGS is a more difficult diagnosis, especially in children with functional gastrointestinal (GI) complaints. NCGS is considered a syndrome of intestinal but also extraintestinal symptoms occurring within hours, but sometimes even after several days of gluten ingestion. In children, the leading symptoms of NCGS are abdominal pain and diarrhea, while extraintestinal symptoms are rare, in contrast to adult patients. No precise diagnostic test nor specific biomarkers exist, except a rather cumbersome three-phase gluten-exposure, gluten-free diet, followed by a blinded placebo-controlled gluten challenge with crossover to provoke symptoms elicited by gluten in a reproducible manner that disappear on gluten-free alimentation. Recent data indicate that the peptide part of wheat proteins is not necessarily the sole trigger of clinical symptoms. Mono- or oligosaccharides, such as fructan and other constituents of wheat, were able to provoke GI symptoms in clinical trials. These new findings indicate that the term gluten sensitivity is probably too restrictive. The incidence of NCGS was reported in the range of 1–10% in the general population and to increase steadily; however, most data are based on patients’ self-reported gluten intolerance or avoidance without a medically confirmed diagnosis. Treatment consists of gluten avoidance for at least several weeks or months. Patients with NCGS require regular reassessment for gluten tolerance allowing with time the reintroduction of increasing amounts of gluten.

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