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Pharmacological interventions on early functional gastrointestinal disorders.

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eMediNexus    20 February 2018

The goal of a study published in the Italian Journal of Pediatrics was to update and critically review the current literature, in order to assess the effects and the clinical appropriateness of drug treatment in early (occurring in infants and toddlers) functional gastrointestinal disorders (FGIDs). This was a systematic review the Medline and GIMBE (Italian Group on Medicine Based on Evidence) databases, according to the methodology of the Critically Appraised Topics (CATs). Systematic reviews and randomized controlled trials (RCTs) concerning pharmacologic therapies in children with early FGIDs were included. No evidence-based guidelines or systematic reviews were found regarding the utility of pharmacological therapy in functional regurgitation, infant colic, and functional diarrhea. In case of regurgitation associated with marked distress, certain evidence supported a short trial with alginate when other non-pharmacological approaches failed. While in constipated infants older than six months of age, polyethylene glycol (PEG) was recommended as the first-line therapy, both for fecal disimpaction and maintenance therapy of constipation. The results indicated that a pharmacological intervention is necessary for rectal disimpaction in childhood constipation and that PEG is the first line therapy.

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