Systematic review on microbiota and functional gastrointestinal disorders

Functional gastrointestinal disorders (FGIDs) refer to a wide range of gastrointestinal tract disorders that lack clear structural or biochemical causes. Although their pathophysiology is unclear, alterations in gut microbiota with potential functional consequences have been described. A systemic review of Hofman et al. (2022) provides an overview of the faecal microbiota of infants and young children with FGIDs compared to healthy children.

Summary

  • Functional gastrointestinal disorders (FGIDs) are common in infants and refer to a wide range of gastrointestinal tract disorders without clear structural or biochemical causes
  • Gut microbiota potentially play a role in the pathophysiology of FGIDs
  • A systematic review of Hofman et al. (2022) included 13 studies that compared the faecal microbiota of infants and young children with and without FGIDs
  • Although there were methodological limitations, data showed differences in microbial diversity, stability and colonization patterns in infants with colic
  • With regards to other FGIDs, insights on microbiota are limited or lacking

Functional gastrointestinal disorders

The paper describes that approximately 50% of all infants are estimated to suffer from at least one FGID during their first months of life. Mentioned examples of FGIDs are infantile colic, gastroesophageal reflux and functional constipation. Except for functional constipation, most FGIDs have been shown to disappear spontaneously within the first year of life. Despite their transient nature, FGIDs can have both short- and long-term health consequences. For example, they can result in feeding difficulties, discontinuation of breastfeeding and an increased risk for developing childhood migraine, asthma or atopic disease.

Gut microbiota

The review paper stipulates that there is growing evidence that the gut microbiota plays an important role in health. For example, it has been shown that the gut microbiota can influence the maturation of the immune system, can impact gut permeability, nutrient absorption, nutrient metabolism and can reduce the risk of pathogen colonization. Research has shown that the faecal microbiota is similar to the microbiota in the large intestine. Therefore, the faecal microbiome is usually studied instead of the gut microbiome.

Systematic review

To assess whether there are differences in the faecal microbiota of children with and without FGIDs, 13 papers were assessed in this review paper. Most of these studies focused on infant colic. The authors conclude that overall, research on this topic is inconclusive, due to the fact that studies used different methodologies. For example, the type of bacterial species measured differed between studies and different inclusion criteria, confounding factors and analytical methods were used.

Despite these methodological limitations, the authors observed that the faecal microbiota of infants with colic showed differences in microbial diversity, stability and colonization patterns. Several studies found less beneficial species in these colicky children, and some studies found more of a certain pathogenic species. Only one study in this review reported on functional constipation. This study found that the stools of these constipated children contained less of a particular beneficial bacterium. The review paper notes that with regards to other FGIDs, insights on microbiota are limited or lacking.

Reference

Hofman, D., Kudla, U., Miqdady, M., Nguyen, T. V. H., Morán-Ramos, S., & Vandenplas, Y. (2022). Faecal Microbiota in Infants and Young Children with Functional Gastrointestinal Disorders: A Systematic Review. Nutrients14(5), 974.