Treatment of functional gastrointestinal disorders in infants

O.L. Krivusha, V.L. Babich, N.Y. Leonenko


The article presents modern information about the main pathogenetic mechanisms and clinical manifestations of functional gastrointestinal disorders in infants according to Rome ІV criteria. The requirements for probiotic preparations used in modern medicine are presented. Attention is focused on the main characteristics of the most studied probiotic strain, Lactobacillus rhamnosus GG. The analysis of the results of clinical studies using Lactobacillus rhamnosus GG for the treatment and prevention of functional and organic diseases in children was carried out. The main pharmacological properties and characteristics of Active Flora baby food supplement are presented, which recently appeared on the pharmaceutical market of Ukraine, the main indications for the use of this food supplement are substantiated.


functional disorders; digestive tract; children; Lactobacillus rhamnosus GG


Abaturov AE, Gerasimenko ONb Vysochina IL, Zavgorodniaia NIu. Defenziny i defenzin-zavisimye zabolevaniia [Defensins and defensin-dependent diseases]. Odesa: VMV; 2011. 265 p. (in Russian).

Abaturov AE, Kriuchko TA, Agafonova EA, Krivusha EL, Nesina IN. Probiotiki i vrachebnaia praktika [Probiotics and medical practice]. Kharkiv: Planeta-Print; 2016. 128 p. (in Russian).

Abaturov АE. The role of probiotics in the formation of microflora in infants fed with formulas. Zdorovʹe rebenka. 2017;12(7):865-872. doi: 10.22141/2224-0551.12.7.2017.118604 (in Russian).

Abaturov AE, Zavgorodniaia NIu. Funktsional'naia dispepsiia u detei [Functional dyspepsia in children]. Kyiv: Ukrai'na; 2017. 54 p. (in Russian).

Antipkin YuG, Volosovets OP, Maidannik VG, et al. Status of child population health - the future of the country (part 1). Zdorovʹe rebenka. 2018;13(1):1-11. doi: 10.22141/2224-0551.13.1.2018.127059. (in Ukrainian).

Belmer SV, Pechkurov DV. The Rome IV criteria: a modern view on functional gastrointestinal disorders. Pediatric Nutrition. 2016;14(5):42-49. (in Russian).

Mazankova LN, Rybalchenko OV, Kornienko EA, Perlovskaya SG. Probiotics in pediatrics: Pros and cons in the context of evidence-based medicine. Rossiyskiy Vestnik Perinatologii i Pediatrii. 2016;61(1):16-26. (in Russian).

Ministry of Нealth of Ukraine. Order on January 29, 2013. On Adoption of Standardized Clinical Protocols of Medical Care for Children with Diseases of the Digestive Organs. Available from: Accessed: January 29, 2013. (in Ukrainian).

Khavkin AI. Mikroflora pishchevaritel'nogo trakta [Microflora of the digestive tract]. Moscow: Fond sotsial'noi pediatrii; 2006. 414 p. (in Russian).

Khavkin AI. Functional bowel disorders in children and the role of probiotics in their correction. Pediatric Nutrition. 2011;13(2):36-43. (in Russian).

Borriello SP, Hammes WP, Holzapfel W, et al. Safety of probiotics that contain lactobacilli or bifidobacteria. Clin Infect Dis. 2003 Mar 15;36(6):775-80. doi: 10.1086/368080.

Cao YN, Feng LJ, Liu YY, et al. Effect of Lactobacillus rhamnosus GG supernatant on serotonin transporter expression in rats with post-infectious irritable bowel syndrome. World J Gastroenterol. 2018 Jan 21;24(3):338-350. doi: 10.3748/wjg.v24.i3.338.

Collado MC, Grześkowiak Ł, Salminen S. Probiotic strains and their combination inhibit in vitro adhesion of pathogens to pig intestinal mucosa. Curr Microbiol. 2007 Sep;55(3):260-5. doi: 10.1007/s00284-007-0144-8.

Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016 May;150(6):1257-61. doi: 10.1053/j.gastro.2016.03.035.

Fong FL, Shah NP, Kirjavainen P, El-Nezami H. Mechanism of Action of Probiotic Bacteria on Intestinal and Systemic Immunities and Antigen-Presenting Cells. Int Rev Immunol. 2016 May 3;35(3):179-88. doi: 10.3109/08830185.2015.1096937.

Ghoshal UC, Park H, Gwee KA. Bugs and irritable bowel syndrome: the good, the bad and the ugly. J Gastroenterol Hepatol. 2010 Feb;25(2):244-51. doi: 10.1111/j.1440-1746.2009.06133.x.

Guarino A, Ashkenazi S, Gendrel D, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014 Jul;59(1):132-52. doi: 10.1097/MPG.0000000000000375.

Hill C, Guarner F, Reid G, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 Aug;11(8):506-14. doi: 10.1038/nrgastro.2014.66.

Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tilburg M. Functional Disorders: Children and Adolescents. Gastroenterology. 2016 Feb 15. pii: S0016-5085(16)00181-5. doi: 10.1053/j.gastro.2016.02.015.

Kuijper EJ, Barbut F, Brazier JS, et al. Update of Clostridium difficile infection due to PCR ribotype 027 in Europe. Euro Surveill. 2008 Jul 31;13(31). pii: 18942.

Laursen RP, Hojsak I. Probiotics for respiratory tract infections in children attending day care centers-a systematic review. Eur J Pediatr. 2018 May 12. doi: 10.1007/s00431-018-3167-1.

Mailänder-Sánchez D, Braunsdorf C, Grumaz C, et al. Antifungal defense of probiotic Lactobacillus rhamnosus GG is mediated by blocking adhesion and nutrient depletion. PLoS One. 2017 Oct 12;12(10):e0184438. doi: 10.1371/journal.pone.0184438.

Mantegazza C, Molinari P, D'Auria E, Sonnino M, Morelli L, Zuccotti GV. Probiotics and antibiotic-associated diarrhea in children: A review and new evidence on Lactobacillus rhamnosus GG during and after antibiotic treatment. Pharmacol Res. 2018 Feb;128:63-72. doi: 10.1016/j.phrs.2017.08.001.

Manzoni P, Mostert M, Leonessa L, et al. Oral supplementation with Lactobacillus casei subspecies rhamnosus prevents enteric colonization by Candida species in preterm neonates: a randomized study. Clin Infect Dis. 2006 Jun 15;42(12):1735-42. doi: 10.1086/504324.

Manzoni P. Use of Lactobacillus casei subspecies Rhamnosus GG and gastrointestinal colonization by Candida species in preterm neonates. J Pediatr Gastroenterol Nutr. 2007 Dec;45(Suppl 3):S190-4. doi: 10.1097/01.mpg.0000302971.06115.15.

McFarland LV, Ship N, Auclair J, Millette M. Primary prevention of Clostridium difficile infections with a specific probiotic combining Lactobacillus acidophilus, L. casei, and L. rhamnosus strains: assessing the evidence. J Hosp Infect. 2018 Aug;99(4):443-452. doi: 10.1016/j.jhin.2018.04.017.

McFarland LV. Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review. Antibiotics (Basel). 2015 Apr 13;4(2):160-78. doi: 10.3390/antibiotics4020160.

Nishiyama K, Nakamata K, Ueno S, et al. Adhesion properties of Lactobacillus rhamnosus mucus-binding factor to mucin and extracellular matrix proteins. Biosci Biotechnol Biochem. 2015;79(2):271-9. doi: 10.1080/09168451.2014.972325.

Ouwehand A, Isolauri E, Salminen S. The role of intestinal microflora for development of the immune system in early childhood. Eur J Nutr. 2002 Nov;41(Suppl 1):I32-7. doi: 10.1007/s00394-002-1105-4.

Pace F, Pace M, Quartarone G. Probiotics in digestive diseases: focus on Lactobacillus GG. Minerva Gastroenterol Dietol. 2015 Dec;61(4):273-92.

Pagnini C, Corleto VD, Martorelli M, et al. Mucosal adhesion and anti-inflammatory effects of Lactobacillus rhamnosus GG in the human colonic mucosa: A proof-of-concept study. World J Gastroenterol. 2018 Nov 7;24(41):4652-4662. doi: 10.3748/wjg.v24.i41.4652.

Pärtty A, Luoto R, Kalliomäki M, Salminen S, Isolauri E. Effects of early prebiotic and probiotic supplementation on development of gut microbiota and fussing and crying in preterm infants: a randomized, double-blind, placebo-controlled trial. J Pediatr. 2013 Nov;163(5):1272-7.e1-2. doi: 10.1016/j.jpeds.2013.05.035.

Pärtty A, Rautava S, Kalliomäki M. Probiotics on Pediatric Functional Gastrointestinal Disorders. Nutrients. 2018 Nov 29;10(12). pii: E1836. doi: 10.3390/nu10121836.

Pigrau M, Rodiño-Janeiro BK, Casado-Bedmar M, et al. The joint power of sex and stress to modulate braingutmicrobiota axis and intestinal barrier homeostasis: implications for irritable bowel syndrome. Neurogastroenterol Motil. 2016 Apr;28(4):463-86. doi: 10.1111/nmo.12717.

Valdés-Varela L, Gueimonde M, Ruas-Madiedo P. Probiotics for Prevention and Treatment of Clostridium difficile Infection. Adv Exp Med Biol. 2018;1050:161-176. doi: 10.1007/978-3-319-72799-8_10.

World Gastroenterology Organisation (WGO). Probiotics and prebiotics 2017: WGO Global Guideline. Available from: Accessed: February 2017.

Yan F, Liu L, Dempsey PJ, et al. A Lactobacillus rhamnosus GG-derived soluble protein, p40, stimulates ligand release from intestinal epithelial cells to transactivate epidermal growth factor receptor. J Biol Chem. 2013 Oct 18;288(42):30742-51. doi: 10.1074/jbc.M113.492397.

Yan F, Polk DB. Characterization of a probiotic-derived soluble protein which reveals a mechanism of preventive and treatment effects of probiotics on intestinal inflammatory diseases. Gut Microbes. 2012 Jan-Feb;3(1):25-8. doi: 10.4161/gmic.19245.

Copyright (c) 2020 CHILD`S HEALTH

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© Publishing House Zaslavsky, 1997-2020


   Seo анализ сайта