Probiotic Properties of Bifidobacterium longum KABP042 and Pediococcus pentosaceus KABP041 Show Potential to Counteract Functional Gastrointestinal Disorders in an Observational Pilot Trial in Infants

Functional gastrointestinal disorders (FGIDs) are a common concern during the first year of life. Recognized as gut-brain axis disorders by Rome IV criteria, FGIDs etiology is linked to altered gut-brain interaction, intestinal physiology, and microbiota. In this regard, probiotics have emerged as a promising therapy for infant FGIDs. In this study, we have investigated the probiotic potential of the strains Bifidobacterium longum KABP042 and Pediococcus pentosaceus KABP041—isolated from healthy children’s feces—in the treatment of FGIDs. To this scope, genome sequences of both strains were obtained and subjected to in silico analyses. No virulence factors were detected for any strain and only the non-transferable erm(49) gene, which confers resistance to erythromycin and clindamycin, was identified in the genome of B. longum KABP042. Safety of both strains was confirmed by acute oral toxicity in rats. In vitro characterization revealed that the strains tolerate gastric and bile challenges and display a great adhesion capacity to human intestinal cells. The two strains mediate adhesion by different mechanisms and, when combined, synergically induce the expression of Caco-2 tight junction proteins. Moreover, growth inhibition experiments demonstrated the ability of the two strains alone and in combination to antagonize diverse Gram-negative and Gram-positive bacterial pathogens during sessile and planktonic growth. Pathogens’ inhibition was mostly mediated by the production of organic acids, but neutralization experiments strongly suggested the presence of additional antimicrobial compounds in probiotic culture supernatants such as the bacteriocin Lantibiotic B, whose gene was detected in the genome of B. longum KABP042. Finally, an exploratory, observational, pilot study involving 36 infants diagnosed with at least one FGID (infant colic and/or functional constipation) showed the probiotic formula was well tolerated and FGID severity was significantly reduced after 14 days of treatment with the 2 strains. Overall, this work provides evidence of the probiotic and synergic properties of strains B. longum KABP042 and P. pentosaceus KABP041, and of their potential to treat pediatric FGIDs.Clinical Trial Registration: [www.ClinicalTrials.gov], [identifier NCT04944628].

Fonksiyonel Gastrointestinal Bozukluklarda Beslenmenin Önemi ve Diyetisyenin Rolü

Fonksiyonel gastrointestinal bozukluklar (FGID-functional gastrointestinal disorders) herhangi bir organik bozukluk olmamasına karşın kronik veya tekrarlayan gastrointestinal semptomlara verilen genel bir addır. Bu bozukluklarda diyetin, hastaya özel olarak hazırlanması ve sürekli izlenmesi çok büyük önem taşımaktadır. Bu süreçte, hastanın beslenme alışkanlıklarının deneyimli diyetisyenler tarafından belirlenmesi ve hasta ile karşılıklı olarak tüm biyo-psiko-sosyal yönler dikkate alınarak incelenmesi, buna göre kişiye özel beslenme ve diyet planının tanzim edilmesi gerekmektedir. FGID’ler arasında en yaygın semptomlar bütünü IBS (Irritable Bowel Syndrome-huzursuz bağırsak sendromu) olarak adlandırılan bozukluktur. IBS’lerde diyetisyenin rolü diğer FGID’lere göre daha da önemli ve özeldir. Türkiye’de diyetisyenlerin bu bozukluklar alanında uzmanlaşması için gerekli adımlar ivedilikle atılmalı ve sağlık kurumlarında diyetisyen kadrosu istihdamı da arttırılmalıdır.

A Narrative Review on the Update in the Prevalence of Infantile Colic, Regurgitation, and Constipation in Young Children: Implications of the ROME IV Criteria

Regurgitation, colic, and constipation are frequently reported Functional Gastrointestinal Disorders (FGIDs) in the first few years of life. In 2016, the diagnostic criteria for FGIDs were changed from ROME III to ROME IV. This review assesses the prevalence of the most frequent FGIDs (colic, regurgitation and constipation) among children aged 0–5 years after the introduction of the later criteria. Articles published from January 1, 2016 to May 1, 2021 were retrieved from PubMed and Google Scholar using relevant keywords. A total of 12 articles were further analyzed based on the inclusion and exclusion criteria. This review consists of two studies (17%) from the Middle East, three (25%) from Asia, two (17%) from the USA, three (25%) from Europe, and one (8%) from Africa. Three studies (25%) were based on data obtained from healthcare professionals, while the rest were parent or caregiver reports. About half of the retrieved studies used the ROME IV criteria. Among infants aged 0–6 months, the reported prevalence of colic ranged between 10–15%, whilst that of regurgitation was 33.9%, and constipation was 1.5%. Among infants aged 0–12 months, the reported prevalence of regurgitation and constipation were 3.4–25.9% and 1.3–17.7%, respectively. The reported prevalence of constipation was 1.3–26% among children aged 13–48 months and 13% among children aged 4–18 years. Despite the large variations due to differences in diagnostic criteria, study respondents and age group, the prevalence of infantile colic was higher, while that for infantile regurgitation and constipation were similar using the ROME IV or III criteria.

Analysis of the assortment of drugs used in functional gastrointestinal disorders at the pharmaceutical market of Ukraine

To study the assortment of drugs and dietary products for treating functional gastrointestinal disorders at the pharmaceutical market of Ukraine in order to determine the feasibility of developing drugs based on the medicinal plant raw material, in particular for children.

A New Criterion for Fluoroquinolone-Associated Disability Diagnosis: Functional Gastrointestinal Disorders

Background and Objectives: Fluoroquinolones (FQs) are a broad-spectrum class of antibiotics routinely prescribed for common bacterial infections despite recent recommendations to use them only for life-threatening cases. In addition to their antimicrobial properties, FQs act in the central nervous system as GABAA receptor inhibitors, which could potentially affect functionality of the vagus nerve at the forefront of gastrointestinal (GI) tract function. Alterations in neural control of digestion have been shown to be linked to Functional Gastrointestinal Disorders (FGIDs), which are usually diagnosed based on self-reported symptoms. The aim of this study was to assess the incidence of FGIDs following FQ use. Materials and Methods: Self-reports from the FDA Adverse Event Reporting System were analyzed together with ~300 survey responses from a social network derived sample to the Bowel Disease Questionnaire. Results: The results of this study suggested that six different FQs are associated with a wide range of GI symptoms not currently reported in the drugs’ labels. The responses from the survey suggested that ~70% of FQ users scored positive for FGID, with no positive correlation between drug type, duration of administration, dosage and frequency of administration. Conclusions: This study showed that GI disorders other than nausea, vomiting and diarrhea are more common than currently reported on the drug labels, and that FGIDs are possibly a common consequence of FQ use even after single use.

Brain Structural Changes in Regions Within the Salience Network in Patients with Functional Constipation

Functional constipation (FCon) is one of the common functional gastrointestinal disorders (FGID). Previous studies reported alterations in cortical morphometry as well as changes in white matter (WM) fiber tracts and thalamo-limbic/parietal structural connectivity (SC). However, whether patients with FCon are implicated in changes in gray matter (GM) volume and associated SC remains unclear. Voxel-based morphometry (VBM) was first employed to examine differences in GM volume between 48 patients with FCon and 52 healthy controls (HC). Diffusion tensor imaging (DTI) with probabilistic tractography analysis was then employed to explore alterations in SC of these regions. Compared with the HC, patients with FCon showed decreased GM volumes in the right middle frontal gyrus (MFG_R), left insula (INS_L), and anterior cingulate cortex (ACC, PFWE < 0.05) which had a negative correlation with abdominal symptoms and difficulty of defecation respectively. Seed-based SC showed patients with FCon had decreased fractional anisotropy (FA) of bilateral INS-ACC, bilateral ACC-MFG, bilateral INS-MFG, increased axial diffusivity (AD) of bilateral ACC-MFG, and decreased radial diffusivity (RD) of bilateral INS-ACC, bilateral ACC-MFG tracts. FA of the right INS-ACC tract had a negative correlation with difficulty of defecation and AD of the ACC-left MFG tract had a negative correlation with stool symptoms. These findings reflect patients with FCon are implicated in changes in GM volumes and corresponding SC in brain regions within the salience network.

The experiences of adolescents diagnosed with functional gastrointestinal disorders: An interpretative phenomenological analysis

The aim of this study was to provide a qualitative perspective of adolescents’ experiences of functional gastrointestinal disorders. In-depth semi structured interviews were conducted with eleven adolescents aged 11–16. The transcripts were analysed using Interpretative Phenomenological Analysis. Three superordinate themes were identified: 1) The journey to diagnosis: the good, the bad and the unknown; 2) Making sense of ‘functional’: the search for meaning; and 3) To share or conceal?: the impact of anticipated stigma on peer disclosure. The themes highlighted a complex process of meaning-making, with limited information about their diagnosis impacting on approaches to self-management and peer disclosure. Findings suggest adolescents would benefit from developmentally appropriate information and resources about the biopsychosocial aetiology of their presentation. It is considered that this may lead to greater self-efficacy in self-management of symptoms and reduce potential for perceived and self-stigma. Further implications for clinical practice and future research are discussed.