Intestinal colic, gastroesophageal reflux (regurgitation) and constipation are the most common functional disorders of the gastrointestinal tract in children in the first year of life and the reasons for going to the pediatrician in the first half of life. Often these seemingly simple problems lead to hospitalization, a change in diet, the use of medication, parental anxiety and the absence of parental work days with corresponding social consequences.

The aim of the study, conducted in Italy and published in the January issue of the journal JAMA Pediatrics for 2014, was to study the hypothesis of the addition of the probiotic Lactobacillus reuteri DSM 17938 to the diet of children the first 3 months of life, reduce the incidence of intestinal colic, gastroesophageal reflux and constipation in term newborns and thus affect the socio- caused by these conditions.

A prospective, multicenter, double-masked, placebo-controlled, randomized clinical trial included children born in 9 different maternity units in Italy from September 1, 2010 to October 30, 2012. Study participants received both breast and artificial feeding.

Parents of children were required to keep a diary in which the number of regurgitations, the duration of persistent crying (minutes per day), the number of bowel movements per day, the number of visits to the pediatrician, changes in diet , hospitalizations, emergency room visits, pharmacological interventions and worker omissions were recorded by parents' days.

A total of 589 children were randomized to receive L. reuteri DSM 17938 or a placebo daily for 90 days. The main results evaluated during the study were the reduction in daily crying time, the number of regurgitations and constipation during the first 3 months of life. In addition, during the works, the cost-effectiveness analysis of the prophylactic use of the probiotic was carried out.

At 3 months of life in the application group L. reuteri DSM 17938 showed statistically significant differences compared to placebo in the average duration of crying (38 min vs 71 min, p less than 0.01), the average number of regurgitations per day (2.9 vs 4.6, p less than 0.01) and the average number of bowel movements per day ( 4.2 vs 3.6, p less than 0.01), respectively.

Intestinal colic is a very common problem and its frequency peaks at 6 weeks of life. It is this problem that causes 10 to 20% of all pediatrician visits in the first 4 months of life. It turned out that by using L. reuteri DSM 17938 allowed an average calculated saving per patient of 88 € for a family and 104 € additional; for the society.

Consequently, the prophylactic use of L. reuteri DSM 17938 during the first 3 months of life reduces the severity of functional gastrointestinal disorders, i.e. reduces the duration of intestinal colic, the number regurgitation and functional constipation, and leads to a reduction in personal and social costs aimed at stopping these conditions.

Intestinal colic in children in the first year of life is thought to be an automatically stopped clinical condition, the etiology of which has not been fully investigated. Numerous studies indicate that, however, early functional gastrointestinal disorders may be predictors of various diseases in the future. Thus, a study has already been published in which data has been presented according to which children with irritable bowel syndrome had a higher percentage of functional gastrointestinal disorders at 1 year compared to children without irritable bowel syndrome.

Although the mechanism underlying the relationship between intestinal colic in the neonatal period and the development of serious problems with the gastrointestinal tract remains unclear in the future, many scientists believe that early pain can contribute to development of long-term visceral hypersensitivity to mucosal permeability. These pathophysiological aspects in the future can upset the balance of the intestinal microflora and contribute to the appearance of unexpressed inflammatory changes. Preventive use of lactobacilli can lead to a change in colonization which, in turn, will help restore the altered patency of the intestinal lining.

Long-term follow-up of children who have received probiotics for a year should highlight the effectiveness of these preventive measures with regard to the long-term effect on intestinal health. To date, systematic reviews and meta-analyzes have not supported the idea of widespread use of probiotics in all children with intestinal colic, without exception. The mechanism of the therapeutic effect of probiotics in such disorders also remains unclear. Despite the relative lack of information on the mechanism of action, the benefits of using probiotics are obvious and there may soon come a point when pediatricians will make recommendations that (verbatim) "5 drops of probiotics per day will solve the problem. problem of colic in young children "(" 5 probiotic drops per day to ward off infant colic "). In addition, the use of probiotics is safe.