Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
권호 표지
DOI QR코드

DOI QR Code

The New Rome IV Criteria for Functional Gastrointestinal Disorders in Infants and Toddlers

  • Zeevenhooven, Judith (Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center) ;
  • Koppen, Ilan J.N. (Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center) ;
  • Benninga, Marc A. (Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center)
  • Received : 2017.01.23
  • Accepted : 2017.02.05
  • Published : 2017.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Functional gastrointestinal disorders (FGIDs) are common worldwide and cover a wide range of disorders attributable to the gastrointestinal tract that cannot be explained by structural or biochemical abnormalities. The diagnosis of these disorders relies on the symptom-based Rome criteria. In 2016 the Rome criteria were revised for infants/toddlers and for children and adolescents. In this review, we discuss the novel Rome IV criteria for infants and toddlers. The criteria for infant colic were drastically changed, whereas only minor changes were made for regurgitation, cyclic vomiting syndrome, functional diarrhea, infant dyschezia and functional constipation. In addition to this, the new Rome IV discusses underlying mechanisms of pain in infants and toddlers, including the neurodevelopment of nociceptive and pain pathways, the various factors that are involved in pain experience, and methods of pain assessment in infants and toddlers is essential for the clinician who encounters functional pain in this age group. Overall, the Rome IV criteria have become more distinctive for all disorders in order to improve the process of diagnosing pediatric FGIDs.

Keywords

References

  1. Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko S. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology 2016;150:1443-55.e2. https://doi.org/10.1053/j.gastro.2016.02.016
  2. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology 2016;150:1262-79.e2. https://doi.org/10.1053/j.gastro.2016.02.032
  3. Rasquin-Weber A, Hyman PE, Cucchiara S, Fleisher DR, Hyams JS, Milla PJ, et al. Childhood functional gastrointestinal disorders. Gut 1999;45 Suppl 2:II60-8.
  4. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006;130:1377-90. https://doi.org/10.1053/j.gastro.2006.03.008
  5. Hyman PE, Milla PJ, Benninga MA, Davidson GP, Fleisher DF, Taminiau J. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology 2006;130:1519-26. https://doi.org/10.1053/j.gastro.2005.11.065
  6. Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006;130:1527-37. https://doi.org/10.1053/j.gastro.2005.08.063
  7. Ferreira-Maia AP, Matijasevich A, Wang YP. Epidemiology of functional gastrointestinal disorders in infants and toddlers: a systematic review. World J Gastroenterol 2016;22:6547-58. https://doi.org/10.3748/wjg.v22.i28.6547
  8. van Tilburg MA, Hyman PE, Walker L, Rouster A, Palsson OS, Kim SM, et al. Prevalence of functional gastrointestinal disorders in infants and toddlers. J Pediatr 2015;166:684-9. https://doi.org/10.1016/j.jpeds.2014.11.039
  9. Chogle A, Velasco-Benitez CA, Koppen IJ, Moreno JE, Ramirez Hernandez CR, Saps M. A population-based study on the epidemiology of functional gastrointestinal disorders in young children. J Pediatr 2016;179:139-43.e1. https://doi.org/10.1016/j.jpeds.2016.08.095
  10. Osatakul S, Sriplung H, Puetpaiboon A, Junjana CO, Chamnongpakdi S. Prevalence and natural course of gastroesophageal reflux symptoms: a 1-year cohort study in Thai infants. J Pediatr Gastroenterol Nutr 2002;34:63-7. https://doi.org/10.1097/00005176-200201000-00015
  11. Nelson SP, Chen EH, Syniar GM, Christoffel KK. Prevalence of symptoms of gastroesophageal reflux during infancy. A pediatric practice-based survey. Pediatric Practice Research Group. Arch Pediatr Adolesc Med 1997;151:569-72. https://doi.org/10.1001/archpedi.1997.02170430035007
  12. Vandenplas Y, Abkari A, Bellaiche M, Benninga M, Chouraqui JP, Cokura F, et al. Prevalence and health outcomes of functional gastrointestinal symptoms in infants from birth to 12 months of age. J Pediatr Gastroenterol Nutr 2015;61:531-7. https://doi.org/10.1097/MPG.0000000000000949
  13. Vandenplas Y, Rudolph CD, Di Lorenzo C, Hassall E, Liptak G, Mazur L, et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr 2009;49:498-547. https://doi.org/10.1097/01.mpg.0000361306.15727.54
  14. Horvath A, Dziechciarz P, Szajewska H. The effect of thickened-feed interventions on gastroesophageal reflux in infants: systematic review and meta-analysis of randomized, controlled trials. Pediatrics 2008;122:e1268-77. https://doi.org/10.1542/peds.2008-1900
  15. Vandenplas Y, Leluyer B, Cazaubiel M, Housez B, Bocquet A. Double-blind comparative trial with 2 antiregurgitation formulae. J Pediatr Gastroenterol Nutr 2013;57:389-93. https://doi.org/10.1097/MPG.0b013e318299993e
  16. van Wijk MP, Benninga MA, Davidson GP, Haslam R, Omari TI. Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants. J Pediatr 2010;156:744-8, 748.e1. https://doi.org/10.1016/j.jpeds.2009.11.006
  17. Task Force on Sudden Infant Death Syndrome, Moon RY. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics 2011;128:e1341-67. https://doi.org/10.1542/peds.2011-2285
  18. Fleisher DR. Infant rumination syndrome: report of a case and review of the literature. Am J Dis Child 1979;133:266-9. https://doi.org/10.1001/archpedi.1979.02130030042006
  19. Fleisher DR, Matar M. The cyclic vomiting syndrome: a report of 71 cases and literature review. J Pediatr Gastroenterol Nutr 1993;17:361-9. https://doi.org/10.1097/00005176-199311000-00005
  20. Li BU, Lefevre F, Chelimsky GG, Boles RG, Nelson SP, Lewis DW, et al. North american society for pediatric gastroenterology, hepatology, and nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr 2008;47:379-93. https://doi.org/10.1097/MPG.0b013e318173ed39
  21. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 2013;33:629-808. https://doi.org/10.1177/0333102413485658
  22. Saps M, Adams P, Bonilla S, Chogle A, Nichols-Vinueza D. Parental report of abdominal pain and abdominal pain-related functional gastrointestinal disorders from a community survey. J Pediatr Gastroenterol Nutr 2012;55:707-10. https://doi.org/10.1097/MPG.0b013e3182662401
  23. Saps M, Nichols-Vinueza DX, Rosen JM, Velasco-Benitez CA. Prevalence of functional gastrointestinal disorders in Colombian school children. J Pediatr 2014;164:542-5.e1. https://doi.org/10.1016/j.jpeds.2013.10.088
  24. Devanarayana NM, Adhikari C, Pannala W, Rajindrajith S. Prevalence of functional gastrointestinal diseases in a cohort of Sri Lankan adolescents: comparison between Rome II and Rome III criteria. J Trop Pediatr 2011;57:34-9. https://doi.org/10.1093/tropej/fmq039
  25. Lewis ML, Palsson OS, Whitehead WE, van Tilburg MA. Prevalence of functional gastrointestinal disorders in children and adolescents. J Pediatr 2016;177:39-43.e3. https://doi.org/10.1016/j.jpeds.2016.04.008
  26. Steutel NF, Benninga MA, Langendam MW, de Kruijff I, Tabbers MM. Reporting outcome measures in trials of infant colic. J Pediatr Gastroenterol Nutr 2014;59:341-6. https://doi.org/10.1097/MPG.0000000000000412
  27. Lucassen PL, Assendelft WJ, van Eijk JT, Gubbels JW, Douwes AC, van Geldrop WJ. Systematic review of the occurrence of infantile colic in the community. Arch Dis Child 2001;84:398-403. https://doi.org/10.1136/adc.84.5.398
  28. James-Roberts IS, Conroy S, Wilsher K. Clinical, developmental and social aspects of infant crying and colic. Infant Child Dev 1995;4:177-89.
  29. St James-Roberts I, Halil T. Infant crying patterns in the first year: normal community and clinical findings. J Child Psychol Psychiatry 1991;32:951-68. https://doi.org/10.1111/j.1469-7610.1991.tb01922.x
  30. Rautava P, Helenius H, Lehtonen L. Psychosocial predisposing factors for infantile colic. BMJ 1993;307:600-4. https://doi.org/10.1136/bmj.307.6904.600
  31. Wolke D. Behavioural treatment of prolonged infant crying: evaluation, methods, and a proposal. In: Barr RG, St James-Roberts I, Keefe MR, eds. New evidence on unexplained early infant crying: its origins, nature and management. Skillman, NJ: Johnson & Johnson Pediatric Institute, 2001:187-208.
  32. Barr RG, St. James-Roberts I, Keefe MR. New evidence on unexplained early infant crying: its origins, nature and management. Skillman, NJ: Johnson & Johnson Pediatric Institute, 2001.
  33. Treem WR. Infant colic. A pediatric gastroenterologist's perspective. Pediatr Clin North Am 1994;41:1121-38. https://doi.org/10.1016/S0031-3955(16)38848-4
  34. Treem WR. Assessing crying complaints: the interaction with gastroesophageal reflux and cow's milk protein intolerance. In: New evidence on unexplained early infant crying: its origins, nature and management. Skillman, NJ: Johnson & Johnson Pediatric Institute, 2001:165-76.
  35. Shamir R. Infant colic and functional gastrointestinal disorders: is there more than a "gut feeling"? J Pediatr Gastroenterol Nutr 2013;57:S1-2.
  36. Barr RG, Young SN, Wright JH, Gravel R, Alkawaf R. Differential calming responses to sucrose taste in crying infants with and without colic. Pediatrics 1999;103:e68. https://doi.org/10.1542/peds.103.5.e68
  37. Lester BM, Boukydis CZ, Garcia-Coll CT, Hole WT. Colic for developmentalists. Infant Ment Health J 1990;11:321-33. https://doi.org/10.1002/1097-0355(199024)11:4<321::AID-IMHJ2280110403>3.0.CO;2-E
  38. DeSantis A, Coster W, Bigsby R, Lester B. Colic and fussing in infancy, and sensory processing at 3 to 8 years of age. Infant Ment Health J 2004;25:522-39. https://doi.org/10.1002/imhj.20025
  39. Milidou I, Sondergaard C, Jensen MS, Olsen J, Henriksen TB. Gestational age, small for gestational age, and infantile colic. Paediatr Perinat Epidemiol 2014;28:138-45. https://doi.org/10.1111/ppe.12095
  40. Douglas P, Hill P. Managing infants who cry excessively in the first few months of life. BMJ 2011;343:d7772. https://doi.org/10.1136/bmj.d7772
  41. Talge NM, Neal C, Glover V; Early Stress, Translational Research and Prevention Science Network: Fetal and Neonatal Experience on Child and Adolescent Mental Health. Antenatal maternal stress and longterm effects on child neurodevelopment: how and why? J Child Psychol Psychiatry 2007;48:245-61. https://doi.org/10.1111/j.1469-7610.2006.01714.x
  42. van den Berg MP, van der Ende J, Crijnen AA, Jaddoe VW, Moll HA, Mackenbach JP, et al. Paternal depressive symptoms during pregnancy are related to excessive infant crying. Pediatrics 2009;124:e96-103. https://doi.org/10.1542/peds.2008-3100
  43. Indrio F, Riezzo G, Raimondi F, Di Mauro A, Francavilla R. Gut motility alterations in neonates and young infants. J Pediatr Gastroenterol Nutr 2013;57:S9-11. https://doi.org/10.1097/01.mpg.0000441926.82812.46
  44. Gupta SK. Is colic a gastrointestinal disorder? Curr Opin Pediatr 2002;14:588-92. https://doi.org/10.1097/00008480-200210000-00005
  45. Rhoads JM, Fatheree NY, Norori J, Liu Y, Lucke JF, Tyson JE, et al. Altered fecal microflora and increased fecal calprotectin in infants with colic. J Pediatr 2009;155:823-8.e1. https://doi.org/10.1016/j.jpeds.2009.05.012
  46. de Weerth C, Fuentes S, Puylaert P, de Vos WM. Intestinal microbiota of infants with colic: development and specific signatures. Pediatrics 2013;131:e550-8. https://doi.org/10.1542/peds.2012-1449
  47. Nooitgedagt JE, Zwart P, Brand PL. Causes, treatment and clinical outcome in infants admitted because of excessive crying to the paediatric department of the Isala clinics, Zwolle, the Netherlands, 1997/'03. Ned Tijdschr Geneeskd 2005;149:472-7.
  48. Lucassen PL, Assendelft WJ, Gubbels JW, van Eijk JT, van Geldrop WJ, Neven AK. Effectiveness of treatments for infantile colic: systematic review. BMJ 1998;316:1563-9. https://doi.org/10.1136/bmj.316.7144.1563
  49. Barr RG. The normal crying curve: what do we really know? Dev Med Child Neurol 1990;32:356-62.
  50. Freedman SB, Al-Harthy N, Thull-Freedman J. The crying infant: diagnostic testing and frequency of serious underlying disease. Pediatrics 2009;123:841-8. https://doi.org/10.1542/peds.2008-0113
  51. Shamir R, St James-Roberts I, Di Lorenzo C, Burns AJ, Thapar N, Indrio F, et al. Infant crying, colic, and gastrointestinal discomfort in early childhood: a review of the evidence and most plausible mechanisms. J Pediatr Gastroenterol Nutr 2013;57 Suppl 1:S1-45.
  52. Wessel MA, Cobb JC, Jackson EB, Harris GS Jr, Detwiler AC. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics 1954;14:421-35.
  53. Barr RG. Excessive crying. In: Sameroff AJ, Lewis M, Miller SM, eds. Handbook of developmental psychopathology. 2nd ed. New York: Kluwer Academic/Plenum Publishers, 2000:327-50.
  54. Fujiwara T, Barr RG, Brant R, Barr M. Infant distress at five weeks of age and caregiver frustration. J Pediatr 2011;159:425-30.e1-2. https://doi.org/10.1016/j.jpeds.2011.02.010
  55. Gustafson G, Wood R, Green J. Can we hear the causes of infants' crying? In: Barr RG, Hopkins B, Green JA, eds. Crying as a sign, a symptom, and a signal. London: Mac Keith Press, 2000:8-22.
  56. James-Roberts IS, Conroy S, Wilsher K. Bases for maternal perceptions of infant crying and colic behaviour. Arch Dis Child 1996;75:375-84. https://doi.org/10.1136/adc.75.5.375
  57. Meyer EC, Coll CT, Lester BM, Boukydis CF, McDonough SM, Oh W. Family-based intervention improves maternal psychological well-being and feeding interaction of preterm infants. Pediatrics 1994;93:241-6.
  58. Vik T, Grote V, Escribano J, Socha J, Verduci E, Fritsch M, et al. Infantile colic, prolonged crying and maternal postnatal depression. Acta Paediatr 2009;98:1344-8. https://doi.org/10.1111/j.1651-2227.2009.01317.x
  59. Kurth E, Kennedy HP, Spichiger E, Hosli I, Stutz EZ. Crying babies, tired mothers: what do we know? A systematic review. Midwifery 2011;27:187-94. https://doi.org/10.1016/j.midw.2009.05.012
  60. Murray L, Cooper P. The impact of irritable infant behavior on maternal mental state: a longitudinal study and a treatment trial. In: Barr RG, St James-Roberts I, Keefe MR, eds. New evidence on unexplained early infant crying: its origins, nature and management. Skillman, NJ: Johnson & Johnson Pediatric Institute, 2001:149-64.
  61. Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggero R, et al. Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo- controlled trial. Pediatrics 2010;126:e526-33. https://doi.org/10.1542/peds.2010-0433
  62. Szajewska H, Gyrczuk E, Horvath A. Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: a randomized, double-blind, placebo-controlled trial. J Pediatr 2013;162:257-62. https://doi.org/10.1016/j.jpeds.2012.08.004
  63. Sung V, Hiscock H, Tang ML, Mensah FK, Nation ML, Satzke C, et al. Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ 2014;348:g2107. https://doi.org/10.1136/bmj.g2107
  64. Sung V, Collett S, de Gooyer T, Hiscock H, Tang M, Wake M. Probiotics to prevent or treat excessive infant crying: systematic review and meta-analysis. JAMA Pediatr 2013;167:1150-7. https://doi.org/10.1001/jamapediatrics.2013.2572
  65. Kramer EA, den Hertog-Kuijl JH, van den Broek LM, van Leengoed E, Bulk AM, Kneepkens CM, et al. Defecation patterns in infants: a prospective cohort study. Arch Dis Child 2015;100:533-6. https://doi.org/10.1136/archdischild-2014-307448
  66. Malowitz S, Green M, Karpinski A, Rosenberg A, Hyman PE. Age of onset of functional constipation. J Pediatr Gastroenterol Nutr 2016;62:600-2. https://doi.org/10.1097/MPG.0000000000001011
  67. Koppen IJ, Lammers LA, Benninga MA, Tabbers MM. Management of functional constipation in children: therapy in practice. Paediatr Drugs 2015;17:349-60. https://doi.org/10.1007/s40272-015-0142-4
  68. Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr 2014;58:258-74.
  69. von Baeyer CL, Champion GD. Commentary: multiple pains as functional pain syndromes. J Pediatr Psychol 2011;36:433-7. https://doi.org/10.1093/jpepsy/jsq123
  70. Lee SJ, Ralston HJ, Drey EA, Partridge JC, Rosen MA. Fetal pain: a systematic multidisciplinary review of the evidence. JAMA 2005;294:947-54. https://doi.org/10.1001/jama.294.8.947
  71. Fitzgerald M. The development of nociceptive circuits. Nat Rev Neurosci 2005;6:507-20.
  72. Lowery CL, Hardman MP, Manning N, Hall RW, Anand KJ, Clancy B. Neurodevelopmental changes of fetal pain. Semin Perinatol 2007;31:275-82. https://doi.org/10.1053/j.semperi.2007.07.004
  73. Fitzgerald M, Walker SM. Infant pain management: a developmental neurobiological approach. Nat Clin Pract Neurol 2009;5:35-50.
  74. Chitkara DK, van Tilburg MA, Blois-Martin N, Whitehead WE. Early life risk factors that contribute to irritable bowel syndrome in adults: a systematic review. Am J Gastroenterol 2008;103:765-74; quiz 775. https://doi.org/10.1111/j.1572-0241.2007.01722.x
  75. Gebhart GF. Pathobiology of visceral pain: molecular mechanisms and therapeutic implications IV. Visceral afferent contributions to the pathobiology of visceral pain. Am J Physiol Gastrointest Liver Physiol 2000;278:G834-8. https://doi.org/10.1152/ajpgi.2000.278.6.G834
  76. Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, et al. Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage 2011;41:1073-93. https://doi.org/10.1016/j.jpainsymman.2010.08.016
  77. Tomlinson D, von Baeyer CL, Stinson JN, Sung L. A systematic review of faces scales for the self-report of pain intensity in children. Pediatrics 2010;126:e1168-98. https://doi.org/10.1542/peds.2010-1609
  78. Slater R, Cantarella A, Gallella S, Worley A, Boyd S, Meek J, et al. Cortical pain responses in human infants. J Neurosci 2006;26:3662-6. https://doi.org/10.1523/JNEUROSCI.0348-06.2006

Cited by

  1. Constipation in the paediatric practice vol.18, pp.5, 2017, https://doi.org/10.36290/ped.2017.054
  2. Cyclic Vomiting Syndrome in Children vol.22, pp.4, 2017, https://doi.org/10.1007/s11916-018-0684-6
  3. Children with cyclic vomiting syndrome: phenotypes, disease burden and mitochondrial DNA analysis vol.18, pp.None, 2018, https://doi.org/10.1186/s12876-018-0836-5
  4. Three-Month Feeding Integration With Bifidobacterium Strains Prevents Gastrointestinal Symptoms in Healthy Newborns vol.5, pp.None, 2017, https://doi.org/10.3389/fnut.2018.00039
  5. Early childhood risk factors for constipation and soiling at school age: an observational cohort study vol.2, pp.1, 2018, https://doi.org/10.1136/bmjpo-2017-000230
  6. Laxative Choice and Treatment Outcomes in Childhood Constipation: Clinical Data in a Longitudinal Retrospective Study vol.21, pp.2, 2017, https://doi.org/10.5223/pghn.2018.21.2.101
  7. Diagnosis and treatment of Helicobacter pylori in the pediatric population vol.70, pp.5, 2017, https://doi.org/10.23736/s0026-4946.18.05346-x
  8. Infantile Colic: An Update vol.55, pp.11, 2017, https://doi.org/10.1007/s13312-018-1423-0
  9. Rationale of Probiotic Supplementation during Pregnancy and Neonatal Period vol.10, pp.11, 2017, https://doi.org/10.3390/nu10111693
  10. Treatment failure in children diagnosed with constipation in a paediatric emergency department in relation to Rome III criteria vol.24, pp.3, 2019, https://doi.org/10.1093/pch/pxy121
  11. The dolichosigma partially located on the right: How justified is the concept of the right slow transit constipation? vol.18, pp.4, 2017, https://doi.org/10.4103/wjnm.wjnm_45_19
  12. Approach to infantile colic in primary care vol.60, pp.1, 2017, https://doi.org/10.11622/smedj.2019004
  13. Neonatal Antibiotic Treatment Is Associated With an Altered Circulating Immune Marker Profile at 1 Year of Age vol.10, pp.None, 2017, https://doi.org/10.3389/fimmu.2019.02939
  14. GUT MICROBIOTA AND THE USE OF PROBIOTICS IN CONSTIPATION IN CHILDREN AND ADOLESCENTS: SYSTEMATIC REVIEW vol.38, pp.None, 2020, https://doi.org/10.1590/1984-0462/2020/38/2018123
  15. Phenotypic expansion of POGZ‐related intellectual disability syndrome (White‐Sutton syndrome) vol.182, pp.1, 2017, https://doi.org/10.1002/ajmg.a.61380
  16. Unraveling the Molecular Mechanisms of Fructus Anisi Stellati as a Remedy for Infantile Colic by Network Pharmacology vol.2020, pp.None, 2017, https://doi.org/10.1155/2020/9210304
  17. Gastroesophageal Reflux Disease and Probiotics: A Systematic Review vol.12, pp.1, 2017, https://doi.org/10.3390/nu12010132
  18. Cyclic derivatives of morphiceptin possess anti-transit effect in the gastrointestinal tract and alleviate abdominal pain in mice vol.72, pp.2, 2017, https://doi.org/10.1007/s43440-020-00084-4
  19. The Effect of Probiotics on Symptoms, Gut Microbiota and Inflammatory Markers in Infantile Colic: A Systematic Review, Meta-Analysis and Meta-Regression of Randomized Controlled Trials vol.9, pp.4, 2017, https://doi.org/10.3390/jcm9040999
  20. A dietary intervention to improve the microbiome composition of pregnant women with Crohn's disease and their offspring: The MELODY (Modulating Early Life Microbiome through Dietary Intervention in Pr vol.18, pp.None, 2017, https://doi.org/10.1016/j.conctc.2020.100573
  21. Functional Gastrointestinal Disorders in Outpatients Aged up to 12 Months: A French Non-Interventional Study vol.17, pp.11, 2020, https://doi.org/10.3390/ijerph17114031
  22. Lactobacillus rhamnosus GG (ATCC 53103) for the Management of Infantile Colic: A Randomized Controlled Trial vol.12, pp.6, 2017, https://doi.org/10.3390/nu12061693
  23. Manual Physical Therapy in the Treatment of Functional Constipation in Children: A Pilot Randomized Controlled Trial vol.26, pp.7, 2020, https://doi.org/10.1089/acm.2020.0047
  24. The impact of incorporating toilet‐training status in the pediatric Rome IV criteria for functional constipation in infant and toddlers vol.32, pp.10, 2017, https://doi.org/10.1111/nmo.13912
  25. The influence of the gastrointestinal microbiome on infant colic vol.14, pp.10, 2017, https://doi.org/10.1080/17474124.2020.1791702
  26. Cyclic Vomiting Syndrome: A Case Report and Mini Literature Review vol.12, pp.11, 2017, https://doi.org/10.7759/cureus.11695
  27. Intolérance au lactose vol.14, pp.8, 2017, https://doi.org/10.1016/j.mmm.2020.10.008
  28. Observing postprandial bowel movements in diaper-dependent toddlers vol.24, pp.4, 2017, https://doi.org/10.1177/1367493519882846
  29. “Fenofibrate as an adjuvant to phototherapy in pathological unconjugated hyperbilirubinemia in neonates: a randomized control trial.” vol.41, pp.4, 2021, https://doi.org/10.1038/s41372-020-00861-2
  30. Infantile colic and the possibilities of their therapeutic influencing vol.22, pp.2, 2017, https://doi.org/10.36290/ped.2021.017
  31. Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet vol.13, pp.5, 2021, https://doi.org/10.3390/nu13051636
  32. 소아 기능성 위장 장애의 한약 치료에 대한 임상연구 동향 - 중의학 무작위 대조군 임상시험을 중심으로 vol.35, pp.3, 2017, https://doi.org/10.7778/jpkm.2021.35.3.67
  33. Impact of early life nutrition on gut health in children: a prospective clinical study vol.11, pp.9, 2017, https://doi.org/10.1136/bmjopen-2021-050432
  34. Fifteen-Years Follow-Up in a Cohort of Children with Functional Gastrointestinal Disorders: Prevalence and Risk Factors to Develop Neuropsychiatric Disorders and Other Comorbidities vol.8, pp.10, 2021, https://doi.org/10.3390/children8100838
  35. An Observational Real-Life Study with a New Infant Formula in Infants with Functional Gastro-Intestinal Disorders vol.13, pp.10, 2017, https://doi.org/10.3390/nu13103336
  36. Non-pharmacological therapy for infantile colic vol.17, pp.None, 2017, https://doi.org/10.21518/2079-701x-2021-17-40-46
  37. Prevalence and trigger factors of functional gastrointestinal disorders among male civil pilots in China vol.11, pp.1, 2017, https://doi.org/10.1038/s41598-021-81825-0
  38. Parasitic infections in Swiss children: Are we overtesting? vol.21, pp.1, 2017, https://doi.org/10.1186/s12876-021-01619-6
  39. Prevalence of functional gastrointestinal disorders in infants and young children in China vol.21, pp.1, 2017, https://doi.org/10.1186/s12887-021-02610-6
  40. Advanced Management Protocol of Transanal Irrigation in Order to Improve the Outcome of Pediatric Patients with Fecal Incontinence vol.8, pp.12, 2017, https://doi.org/10.3390/children8121174
  41. Parentally reported early childhood upper gastrointestinal symptoms alleviate at school age vol.111, pp.1, 2017, https://doi.org/10.1111/apa.16106
  42. Probiotics for preventing and treating infant regurgitation: A systematic review and meta‐analysis vol.18, pp.1, 2017, https://doi.org/10.1111/mcn.13290