Search Results (84)

Functional gastrointestinal disorders (FGIDs) affect over 40% of the global population and represent a substantial health and economic burden. Gandhaga Dravagam (GD) is a classical Siddha mineral-based distillate prepared from sulfur, potassium nitrate, and alum, traditionally indicated for gastrointestinal complaints such as diarrhea, indigestion, and colonic spasm. This study aimed to standardize GD using organoleptic and physicochemical evaluation, qualitative acid-radical and basic-radical tests, elemental analysis by Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES), and X-ray Diffraction (XRD), as well as to assess its antispasmodic potential against acetylcholine (ACh)-induced contractions in an isolated rat ileum model. GD was a clear acidic liquid (pH 2.05 at 10% aqueous dilution) with a specific gravity of 1.0142 at 25 °C. Qualitative analysis confirmed carbonate, sulfate, phosphate, and nitrate radicals. ICP-OES identified sulfur (501.254 mg/L) as the predominant element, followed by aluminum (155.341 mg/L), potassium (100.121 mg/L), phosphorus (56.341 mg/L), and sodium (1.320 mg/L); arsenic, mercury, lead, manganese, and magnesium were below detection limits. XRD revealed crystalline inorganic phases consistent with the sulfur-, potassium-, and aluminum-based constituents. At a single concentration (2% v/v), GD reduced ACh-induced contractile responses by 40.74–56.25% across all ACh concentrations tested (5–80 µg), indicating a consistent antispasmodic effect. These findings provide a preliminary analytical and pharmacological characterization of GD and warrant further mechanistic, toxicological, and clinical evaluation. Full article

Introduction: Functional gastrointestinal disorders (FGIDs), conceptualized as disorders of gut–brain interaction, are among the most common chronic or recurrent conditions in childhood, affecting approximately 20–30% of children worldwide across community and clinical settings. FGIDs are associated with substantial impairments in quality of life, frequent school absences, and high levels of psychological comorbidity, contributing to a considerable burden for families and healthcare systems. Despite their high prevalence, the pathophysiology remains incompletely understood, with evidence pointing to a multifactorial interplay of biological, psychological, and environmental factors. Given their frequency across healthcare settings and their significant psychosocial and economic impact, a better characterization of FGIDs in real-world pediatric populations is needed. This retrospective chart review aimed to examine patterns of FGIDs and their associations with gender, temporal factors, geographic setting, and hospitalization burden in a Swiss pediatric cohort within a biopsychosocial framework. Methods: This retrospective chart review study included 1445 patients aged 0–18 years. Patients were selected based on having received an ICD-10 diagnosis attributed to FGID. The frequency and distribution of the aforementioned factors were determined, as well as their associations with each other. Results: A male predominance of FGIDs in newborns (p < 0.001), a female predominance in adolescents (p < 0.001), and sex-based differences in subtype distribution (p < 0.001) was found in this cohort of patients. A higher proportion of FGID cases were found among children in urban areas than in rural and suburban areas. Infants were hospitalized for significantly longer periods on average than older children and males were hospitalized for longer periods on average than females. Discussion and Conclusions: These findings highlight the importance of early, integrated, interdisciplinary care pathways. Given the growing mental health issues affecting adolescent girls and the well-documented bidirectional relationship between emotional stress and FGID symptoms, it is suggested that early psychological screening and family-based interventions could reduce the chronicity of symptoms, prevent unnecessary hospitalizations and improve long-term health outcomes. Full article

Background: Congenital sucrase–isomaltase deficiency (CSID) may mimic functional gastrointestinal disorders (FGIDs) and is likely underrecognized in pediatric practice. This study aimed to determine the frequency of sucrase–isomaltase (SI) gene variants among children with FGIDs and to evaluate genotype–phenotype associations and treatment-related quality-of-life outcomes. Methods: In this prospective cross-sectional study, children aged 0–18 years diagnosed with FGIDs according to Rome IV criteria were enrolled between May 2022 and January 2023. All patients underwent next-generation sequencing for SI gene variants. Clinical characteristics, FGID subtypes, and anthropometric data were recorded. Variant-positive patients received dietary sucrose restriction, and selected patients were treated with sacrosidase enzyme replacement. Symptom severity was assessed using the Numeric Rating Scale, and quality of life was evaluated with the Pediatric Quality of Life Inventory (PedsQL 4.0). Results: Among 290 children with FGIDs, SI gene variants were identified in 17 patients (5.9%). Variants were more frequently detected in children with irritable bowel syndrome–like symptoms. Clinical presentation was heterogeneous, and no consistent genotype–phenotype correlation was observed. Dietary intervention was associated with symptom improvement in compliant patients, while sacrosidase therapy led to significant improvements in both child- and parent-reported PedsQL scores. Conclusions: Sucrase–isomaltase deficiency is not uncommon among children with FGIDs and should be considered, particularly in those with IBS-like symptoms or diet-related complaints. Integrating genetic evaluation with targeted dietary and enzyme-based therapy may improve symptom control and quality of life in selected pediatric patients. Full article

Background: Functional gastrointestinal disorders (FGIDs) are highly prevalent among infants. Exclusive breastfeeding has been consistently associated with better gastrointestinal health. However, current evidence regarding the associations between early feeding practices and infant gastrointestinal development remains limited. Objectives: To examine the associations between early feeding practices at 1 month of age and gastrointestinal symptoms and overall gastrointestinal burden in infants during the first 12 months of life. Methods: In this multicenter prospective cohort study, 669 healthy mother–infant pairs were finally included. According to feeding practices at 1 month of age, infants were categorized into three groups: exclusive direct breastfeeding (EDB, n = 236, 35.28%), bottle-fed expressed breastmilk (EBB, n = 150, 22.42%), and mixed feeding (MF, n = 283, 42.30%). Gastrointestinal (GI) symptoms were assessed using the Infant Gastrointestinal Symptom Questionnaire (IGSQ) and symptom items from the PedsQL™ Infant Scales. Generalized estimating equations (GEEs) were used to assess the associations. Results: Infants in the EDB group had the lowest incidence of GI symptoms and lower IGSQ scores throughout the follow-up period. Compared with EDB, the MF group showed higher IGSQ scores (β = 0.95, p = 0.002) and higher odds of constipation (OR = 1.64, p < 0.001), vomiting (OR = 1.70, p < 0.001), and swallowing difficulty (OR = 1.79, p = 0.002); these associations remained robust across multiple sensitivity analyses. The EBB group showed higher odds of certain symptoms in the main analysis, but sensitivity analyses (e.g., time-varying exposure) indicated that these associations were not robust, except for bloating (OR = 1.31, p = 0.042). Conclusions: The EDB is the optimal strategy for infant gastrointestinal health and should be prioritized. The MF is robustly associated with increased odds of constipation, vomiting, swallowing difficulty, and overall gastrointestinal burden. The EBB may slightly increase the odds of bloating, which can be mitigated by paced feeding and adequate burping. Full article

Background and Objectives: This prospective, non-interventional, multicenter study aims to assess the therapeutic effectiveness of trimebutine maleate in patients with functional gastrointestinal disorders (FGIDs) by patient-reported outcomes. Materials and Methods: The study encompassed 2501 patients from 50 clinical sites diagnosed with irritable bowel syndrome, functional dyspepsia, or other functional gastrointestinal diseases. A validated questionnaire, an adapted version of the Izumo scale, was employed for self-assessment of symptoms and quality of life related to gastrointestinal issues. Results: The findings indicate a significant decrease in symptom severity, encompassing epigastric pain, dyspeptic symptoms, and defecation difficulties, as early as the second visit, with mean pain scores declining from 2.65 to 0.46 (p < 0.001). Conclusions: The data validate trimebutine’s profile as a well-tolerated and efficacious therapy for patients with IBS in real-world clinical practice in Bulgaria. The findings endorse the prospective inclusion of trimebutine as a treatment option in forthcoming clinical guidelines. Full article

Introduction: Pediatric Functional Gastrointestinal Disorders (FGIDs), including infantile colic and constipation, may persist into later childhood and adulthood, sometimes manifesting as functional abdominal pain (FAP). Early exposure to probiotics during critical developmental windows may influence long-term susceptibility to disease. Background/Objectives: Building on our original randomized controlled trial, which demonstrated that Lactobacillus reuteri DSM 17938 reduced acute infantile FGID symptoms, a 10-year follow-up study was performed to evaluate whether this early intervention provided lasting protection against FAP in childhood. Methods: Two hundred participants from the original RCT cohort completed follow-up assessments at age ten. The primary outcome was the presence of FAP, analyzed according to the original randomization group (probiotic vs placebo). FAP was diagnosed at age 10 using the Rome IV criteria, based on a standardized clinical assessment by a pediatric gastroenterologist who was blinded to the original allocation. Results: FAP was diagnosed in 13/99 (13.1%) children in the probiotic group and 81/101 (80.2%) in the placebo group, corresponding to an absolute risk reduction of 67.1% (95% CI 56.8–77.3) and a relative risk of 0.16 (95% CI 0.10–0.27) (p < 0.001). Conclusions: Early supplementation with L. reuteri DSM 17938 was associated with a markedly lower prevalence of FAP at age 10. However, the long-term follow-up was observational and characterized by a 57.2% attrition rate. In addition, longitudinal data on potential confounders were unavailable; therefore, the findings should be interpreted as an association rather than proof of causality. Full article

Objective: This narrative review summarizes current evidence on the associations between ultra-processed food (UPF) consumption, childhood and adolescent obesity, and functional gastrointestinal disorders (FGIDs), and examines the metabolic, inflammatory, microbial, and gut–brain mechanisms underlying these links. Methods: A comprehensive search of PubMed and Scopus identified articles published between January 2010 and September 2025. Eligible studies included human research in individuals aged 0–18 years; adult studies were considered when contributing relevant mechanistic insights. Of 335 records screened, 112 studies met the inclusion criteria and were synthesized narratively according to methodological appropriateness. Results: High UPF intake was consistently associated with increased adiposity, metabolic dysregulation, and greater cardiometabolic risk in youth. Children with overweight or obesity showed a higher prevalence of FGIDs compared with their normal-weight peers. Mechanistic evidence suggests that UPFs, rich in refined carbohydrates, unhealthy fats, and additives, may promote gut microbiota dysbiosis, impair intestinal barrier integrity, alter motility, and induce low-grade inflammation, thereby disrupting gut–brain signaling and contributing to FGID symptoms. Early-life and maternal UPF exposure may further increase susceptibility to metabolic and gastrointestinal disturbances through epigenetic and microbiome-mediated pathways. Conclusions: UPFs emerge as a shared etiological factor for obesity and FGIDs in childhood. This review contributes an integrated synthesis of epidemiological and mechanistic data while highlighting key research gaps, particularly the need for standardized methodologies and pediatric interventional studies to strengthen the evidence base. Full article

Background/Objectives: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition often accompanied by gastrointestinal (GI) symptoms and gut microbiota imbalances. The microbiota–gut–brain (MGB) axis is a bidirectional communication network linking gut microbes, the GI system, and the central nervous system (CNS). This narrative review explores the role of the MGB axis in ASD pathophysiology, focusing on communication pathways, neurodevelopmental implications, gut microbiota alteration, GI dysfunction, and emerging therapeutics. Methods: A narrative review methodology was employed. We searched major scientific databases including PubMed, Scopus, and Google Scholar for research on MGB axis mechanisms, gut microbiota composition in ASD, dysbiosis, leaky gut, immune activation, GI disorders, and intervention (probiotics, prebiotics, fecal microbiota transplantation (FMT), antibiotics and diet). Key findings from recent human, animal and in vitro studies were synthesized thematically, emphasizing mechanistic insights and therapeutic outcomes. Original references from the initial manuscript draft were retained and supplemented for comprehensiveness and accuracy. Results: The MGB axis involves neuroanatomical, neuroendocrine, immunological, and metabolic pathways that enable microbes to influence brain development and function. Individuals with ASD commonly exhibit gut dysbiosis characterized by reduced microbial diversity (notably lower Bifidobacterium and Firmicutes) and overpresentation of potentially pathogenic taxa (e.g., Clostridia, Desulfovibrio, Enterobacteriaceae). Dysbiosis is associated with increased intestinal permeability (“leaky gut”) and newly activated and altered microbial metabolite profiles, such as short-chain fatty acids (SCFAs) and lipopolysaccharides (LPSs). Functional gastrointestinal disorders (FGIDs) are prevalent in ASD, linking gut–brain axis dysfunction to behavioral severity. Therapeutically, probiotics and prebiotics can restore eubiosis, fortify the gut barrier, and reduce neuroinflammation, showing modest improvements in GI and behavioral symptoms. FMT and Microbiota Transfer Therapy (MTT) have yielded promising results in open label trials, improving GI function and some ASD behaviors. Antibiotic interventions (e.g., vancomycin) have been found to temporarily alleviate ASD symptoms associated with Clostridiales overgrowth, while nutritional strategies (high-fiber, gluten-free, or ketogenic diets) may modulate the microbiome and influence outcomes. Conclusions: Accumulating evidence implicates the MGB axis in ASD pathogenesis. Gut microbiota dysbiosis and the related GI pathology may exacerbate neurodevelopmental and behavioral symptoms via immune, endocrine and neural routes. Interventions targeting the gut ecosystem, through diet modification, probiotics, symbiotics, or microbiota transplants, offer therapeutic promise. However, heterogeneity in findings underscores the need for rigorous, large-scale studies to clarify causal relationships and evaluate long-term efficacy and safety. Understanding MGB axis mechanisms in ASD could pave the way for novel adjunctive treatments to improve the quality of life for individuals with ASD. Full article

Background: A subset of patients with chronic dyspepsia exhibits palpable upper abdominal hardness and systemic symptoms like headache, chest discomfort, neck/shoulder stiffness, fatigue, and depression. In traditional Korean medicine (TKM), this symptom complex is referred to as Damjeok syndrome (痰积症候群, DJS). Although DJS is frequently observed in TKM practice, it lacks a clear case definition and biological mechanism, limiting its integration in gastroenterology research and evidence-based practice. Clarifying its clinical and biological features is essential to understand its pathophysiology and clinical significance. Methods: This case–control study aimed to characterize DJS by comparing 16 female patients diagnosed with DJS and 15 age-matched healthy females as controls. A female-only cohort was selected to reflect the higher prevalence of chronic dyspepsia in women and reduce biological variability. Clinical characteristics and potential DJS-specific biomarkers were evaluated through complete blood count (CBC), serum biochemical tests, heart rate variability (HRV) for autonomic function, and plasma 5-hydroxyindoleacetic acid (5-HIAA), a serotonin metabolite linked to gastrointestinal motility and autonomic regulation. Results: The DJS group had a mean disease duration of 58.0 ± 46.2 months, with epigastric fullness and underlying abdominal hardness as primary complaints. Postprandial distress syndrome (PDS) was the most common (43.8%) dyspepsia subtype, often combined with epigastric pain syndrome (EPS). Extra-gastrointestinal symptoms such as headache/fatigue (87.5%) and anxiety/depression (81.3%) were highly prevalent. Neutrophil counts were significantly lower in the DJS group (p = 0.01), while other hematological or biochemical markers showed no differences (p > 0.1). HRV analysis revealed decreased parasympathetic activity (RMSSD and HF, p < 0.1), and plasma 5-HIAA levels were significantly elevated compared to healthy controls (p = 0.01). Conclusions: DJS aligns with functional gastrointestinal disorders (FGIDs), sharing psychosomatic symptoms and reduced parasympathetic activity, suggesting gut–brain axis dysregulation. However, distinct features like palpable upper abdominal hardness and elevated plasma 5-HIAA levels indicate that DJS may represent a unique subtype within the category of FGIDs. These findings highlight the need for larger, well-designed studies to further elucidate the pathophysiology of DJS. Full article

Background: Autism Spectrum Disorder (ASD) is increasingly associated with alterations in gut microbiota, intestinal permeability, and immune dysregulation. However, integrative studies exploring these mechanisms in Latin American populations are lacking. Objective: To characterize gut microbiota profiles in Colombian children with ASD and evaluate the effects of two microbiota-targeted interventions, an anti-inflammatory diet and a probiotic formulation, on microbial diversity and taxonomic composition. Methods: In a two-phase study, shotgun metagenomic sequencing was performed on fecal samples from 23 children with ASD and 7 typically developing (TD) controls. In the second phase, 17 children with ASD were randomized to receive a 12-week intervention (anti-inflammatory diet, probiotics, or no intervention). Alpha diversity indices (Shannon, Pielou, and Chao1) and differential abundance analyses were conducted. Results: Compared to TD children, those with ASD showed a higher Firmicutes/Bacteroidetes ratio and a significantly increased abundance of genera such as Clostridioides, Thomasclavelia, Alistipes, and Coprococcus. The presence of functional gastrointestinal disorders (FGIDs) in ASD patients is associated with reduced microbial richness. POST-intervention, the anti-inflammatory diet group showed that no statistically significant changes in alpha diversity were observed, although a slight upward trend was noted and significant enrichment of six bacterial genera, including Moraxella and Eubacterium. The probiotic group exhibited a significant increase in Romboutsia and a decrease in Lachnospira. Cytokine–microbiota networks in ASD were fragmented and dominated by IFN-γ and MCP-1 hubs, indicating systemic immune activation. Interventions induced functional remodeling: The anti-inflammatory diet increased the number of beneficial genera (Eubacterium, Adlercreutzia) and shifted networks toward positive correlations involving IL-8 and MIP-1β. Probiotics increased Romboutsia, reduced Lachnospira, and restructured networks with regulatory cytokines (SDF-1α, Eotaxin) and SCFA-producing taxa (Blautia, Roseburia). Conclusions: Children with ASD in Colombia displayed distinct microbial profiles characterized by pro-inflammatory taxa and altered richness. Both the anti-inflammatory diet and probiotics produced compositional shifts in the gut microbiota, although global changes in diversity were limited. These findings support the potential of microbiota-targeted nutritional strategies for ASD and underscore the need for precision interventions tailored to specific clinical and microbial phenotypes. Full article

Autism Spectrum Disorder (ASD) is frequently accompanied by gastrointestinal disturbances, dietary selectivity, and altered stress responses, with growing evidence pointing to gut–brain axis involvement. While intestinal microbiota has been extensively studied, the role of the oral microbiota remains underexplored. This study investigates the associations between oral microbiota composition and behavioral, gastrointestinal, dietary, and neuroendocrine parameters in children with ASD. A total of 45 children aged 2–18 years comprised the study group. Data collection included oral swabs for 16S rRNA gene sequencing, salivary cortisol sampling, dietary records, and standardized behavioral assessments using the Vineland Adaptive Behavior Scale. A total of 363 microbial species across 11 phyla were identified. Significant correlations were observed between specific bacterial taxa and functional gastrointestinal disorders (FGIDs), dietary patterns, salivary cortisol rhythms, and functioning. Children with FGIDs, food selectivity, or macronutrient imbalances exhibited enriched pro-inflammatory taxa (e.g., Selenomonas, Megasphaera), whereas those with typical cortisol secretion or higher adaptive functioning showed greater microbial diversity and abundance of health-associated genera (e.g., Bifidobacterium dentium). These findings suggest that oral microbiota profiles may reflect systemic physiological and neurobehavioral traits in children with ASD. Further longitudinal studies are needed to clarify causal relationships and support the development of microbiota-targeted interventions. Full article

Background: Between 40 and 70% of the population with autism have been found to suffer from functional gastrointestinal disorders (FGIDs). The emergence of FGIDs is related to lower quality of life and greater medical resources, somatization and emotional instability. There is a paucity of research available that examines gastrointestinal symptoms and sensory responses in individuals with autism in different countries and cultures. The aim of the present study is to compare the possible differences between gastrointestinal symptoms and sensory reactivity between two samples of individuals with autism from Spain and Colombia. Methods. Differences in gastrointestinal symptoms and sensory response were analysed between individuals with autism from Spain (n = 65; mean age = 8.91, SD = 4.02) and Colombia (n = 62; mean age = 10.16, SD = 5.31). Results. No differences were found as a function of age, sex and autism severity between Spanish and Colombian participants. More severe functional nausea and vomiting was reported by the Colombian sample when compared with the Spanish sample (p < 0.00, d = 0.42). Similarly, greater sensory reactivity emerged in Colombian individuals with autism relative to Spanish individuals with autism. Conclusions. Due to methodological limitations, sample size and other factors that could not be analysed in this research, it is not possible to draw conclusions about the influences of cultural or biological factors on gastrointestinal symptomatology and sensory reactivity among both autistic populations. This work could encourage more rigorous cross-cultural research in the future. Full article

Introduction: Functional gastrointestinal disorders (FGIDs) are common comorbidities that affect the life quality of children with autism. Objective: This study investigated the link between clinical history and specific colonic fecal microbiota (CFM) markers with the pathophysiology of FGIDs in young children with autism patients. Methods: Thirty-nine young patients (2 and 18 years) were included in the study of FGIDs (+) cases (n = 18) and FGIDs (-) (n = 21) controls. Gastrointestinal disorders were diagnosed by standardized clinical tools (ROMA-IV and six-item gastrointestinal severity index), while bacterial markers, including Bacteroidetes, Firmicutes, Actinomycetes (Phyla); Lactobacillales, Clostridiales, Bifidobacteriales (Orders); B. fragilis, F. prausnitzii, B. longum, D. vulgaris and A. muciniphila (Species), were detected by targeting 16S rRNA and two-step PCR protocol. Results: The overall prevalence of FGIDs was significantly (p < 0.05) associated with cesarean delivery, the duration of milk formula consumption, and the presence of early intestinal symptoms during infancy. Furthermore, Bacteroidetes, Lactobacillales, B. longum, D. vulgaris, and A. muciniphila concentrations were significantly (p ≤ 0.03) higher in stool of patients with moderate symptoms, compared to those who were asymptomatic. Conclusions: Our results suggest that the CFM composition is a potential physiological predictor of FGID pathophysiology in a severity-dependent way in children with autism. Full article

Background/Objectives: The gut microbiota is involved in modulating gastrointestinal function and consequently contributes to the manifestation of functional gastrointestinal disorders (FGIDs). The aim of the study was to analyze the composition of the gut microbiota in infants with functional gastrointestinal disorders (infantile colic, functional constipation, gastroesophageal reflux, functional diarrhea) according to age, environmental factors, and clinical manifestations. Methods: The study involved the clinical and laboratory examination of 134 infants divided into two groups: group I (n = 82) with FGIDs according to Rome IV criteria, divided into four subgroups (infantile colic, functional constipation, gastroesophageal reflux, and functional diarrhea), and group II (n = 52) without FGIDs. To assess the composition of intestinal microbiota, a bacteriological analysis of fecal samples was performed. Results: Infants with functional gastrointestinal disorders presented an imbalance of intestinal microflora, which was characterized by a significant decrease in the main representatives of acidifying flora represented by Lactobacillus, Bifidobacterium, and Enterococcus and high abundance of proteolytic microorganisms from the Enterobacteriaceae family such as Klebsiella species and Escherichia coli. In infants born by cesarean section or artificially fed, the incidence of functional gastrointestinal disorders and intestinal dysbiosis was significantly higher. Conclusions: The imbalance of acidifying and proteolytic microbial composition in the gut could be the key to the occurrence of functional gastrointestinal disorders in the first year of life. Full article

The purpose of this study was to propose a new diagnostic approach using ultrasound imaging equipment. Many patients suffer from constipation, and medical professionals have difficulty providing treatment and care. The prevalence of constipation increases with age, and this condition strongly impacts the quality of life. Herein, a new diagnostic approach using ultrasound imaging equipment was examined. The study design was a narrative review, and the authors discussed existing knowledge, challenges, and prospects based on previous research. References were obtained by searching PubMed and Centralblatt für die gesammte Medicine. Most of the papers were published in English. Papers with scientific knowledge that has already been published in academic journals were extracted from these documents. No restrictions were placed on the publication date, sample size, study design, or age of subjects, and only published papers reporting scientific knowledge and consensus were cited. As a result, we suggest that this approach classifies the state of fecal retention in the rectum into three patterns. If ultrasound imaging indicates that the rectum is free of feces, there is no need to administer an enema. If hard stool is found, dissection can be performed to prevent complications such as severe intestinal perforation due to subsequent administration of laxatives. If ultrasound imaging reveals normal stool in the rectum, inducing defecation with suppositories may enable treatment for constipation. Full article