МЛАДЕНЧЕСКИЕ КОЛИКИ
Аннотация
Лекция посвящена актуальной проблеме педиатрии — младенческим коликам. Они рассматриваются в свете рекомендаций Римских критериев, отражающих мнение экспертов — педиатров, гастроэнтерологов, аллергологов. Ключевым моментом в постановке диагноза младенческих колик является исключение органической патологии («красные флаги»), которая составляет не более 5%. В статье рассмотрены современные представления о патогенетических механизмах младенческих колик и основанные на этих данных современные принципы их лечения. Терапия младенческих колик включает психологическую поддержку семьи, сохранение грудного вскармливания и применение пробиотиков.
Литература
Хавкин А.И., Файзуллина Р.А., Бельмер С.В. и др. Диагностика и тактика ведения детей с функциональными запорами. Рекомендации общества детских гастроэнтерологов. Вопросы детской диетологии. 2014; 12(4): 49–65.
Wolke D., Bilgin A., Samara M. Systematic review and meta-analysis: fussing and crying durations and prevalence of colic in infants. J Pediatr. 2017; 185: 55–61. DOI: 10.1016/j.jpeds.2017.02.020.
Heine R.G. Gastroesophageal reflux disease, colic and constipation in infants with food allergy. Curr Opin Allergy Clin Immunol. 2006; 6: 220–5. DOI: 10.1097/01.all.0000225164.06016.5d.
Wessel M.A., Cobb J.C., Jackson E.B. et al. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954; 14: 421–35. PMID: 13214956.
Benninga M.A., Faure C., Hyman P.E. et al. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2016: S0016-5085(16)00182-7–1455. DOI: 10.1053/j.gastro.2016.02.016.
Morris S., James-Roberts I.S., Sleep J., Gillham P. Economic evaluation of strategies for managing infant crying and sleep problems. Arch Dis Child. 2001; 84(1): 15–9. PMCID: PMC1718606 DOI: 10.1136/adc.84.1.15.
Halpern R., Coelho R. Excessive crying in infants. J Pediatr. 2016; 92: S40–5. DOI: 10.1016/j.jped.2016.01.004 11.
Steutel N.F., Zeevenhooven J., Scarpato E. et al. Prevalence of functional gastrointestinal disorders in european infants and toddlers. J Pediatr. 2020; 221: 107–14. DOI: 10.1016/j.jpeds.2020.02.076.
Гурова М.М. Младенческая колика с позиций доказательной медицины: распространенность, принципы дифференциальной диагностики, алгоритм выбора диетотерапии. Медицинский совет. 2019; (17): 147–55. DOI: 10.21518/2079-701X-2019-17-147-155.
Steutel N.F., Benninga M.A., Langendam M.W. et al. Developing a core outcome set for infant colic for primary, secondary and tertiary care settings: a prospective study. BMJ Open. 2017; 7: e015418. DOI: 10.1136/bmjopen-2016-015418.
Johnson J.D., Cocker K., Chang E. Infantile colic: recognition and treatment. Am Fam Physician. 2015; 92: 577–82.
Kurth E., Spichiger E., Cignacco E. et al. Predictors of crying problems in the early postpartum period. J Obstet Gynecol Neonatal Nurs. 2010; 39: 250–62. PMID: 20576068. DOI: 10.1111/j.1552-6909.2010.01141.x.
Howard C.R., Lanphear N., Lanphear B.P. et al. Parental responses to infant crying and colic: the effect on breastfeeding duration. Breastfeed Med. 2006; 1: 146–55. DOI: 10.1089/bfm.2006.1.146.
Overpeck M.D., Brenner R.A., Trumble A.C. et al. Risk factors for infant homicide in the United States. N Engl J Med. 1998; 339: 1211–6. DOI: 10.1056/NEJM199810223391706.
Indrio F., Dargenio V.N., Francavilla R. et al. Infantile Colic and Long-Term Outcomes in Childhood: A Narrative Synthesis of the Evidence. Nutrients. 2023; 15(3): 615. DOI: 10.3390/nu15030615.
Partty A., Kalliomaki M., Salminen S. Infant distress and development of functional gastrointestinal disorders in childhood: is there a connection? JAMA Pediatr. 2013; 167: 977–8.
Savino F., Castagno E., Bretto R. et al. A prospective 10-year study on children who had severe infantile colic. ActaPaediatr Suppl. 2005; 94: 129–32.
Romanello S., Spiri D., Marcuzzi E. et al. Association between childhood migraine and history of infantile colic. JAMA. 2013; 309: 1607–12.
Barr R. The normal crying curve: what do we really know? Dev. Med. Child Neurol. 1990; 32(4): 356–62.
Trevarthen C., Aitken K.J. Regression Periods in Human Infancy; ed. M. Heimann. Mahwah, NJ: Lawrence Erlbaum Associates; 2003: 107–84.
Пучкова А.А., Дегтярева А.В., Жданова С.И., Голубцова Ю.М. Младенческие колики: современный взгляд на патогенетические механизмы и лечебные мероприятия (обзор). Неонатология: новости, мнения, обучение. 2021; 9(1): 50–9. DOI: 10.33029/2308-2402-2021-9-1-50-59.
Новикова В.П., Богданова Н.М., Магамедова Д.М., Лапин С.В., Кузнецова Д.А. К вопросу о патогенезе младенческих колик/ В сборнике: Актуальные проблемы абдоминальной патологии у детей. Материалы Юбилейного XXX Конгресса детских гастроэнтерологов России и стран СНГ. 2023. 31–33.
İnce T., Akman H., Çimrin D., Aydın A. The role of melatonin and cortisol circadian rhythms in the pathogenesis of infantile colic. World J Pediatr. 2018; 14(4): 392–8. DOI: 10.1007/s12519-018-0130-1.
Camilleri M., Park S.-Y., Scarpato E., Staiano A. Exploring hypotheses and rationale for causes of infantile colic. Neurogastroenterol. Motil. 2017; 29(2). Article ID 12943.
Анастасевич Л.А. Кишечные колики у детей раннего возраста: причины, диагностика, лечение. РМЖ. 2008; 3: 154–7.
Приворотский В.Ф., Луппова Н.Е. Младенческие кишечные колики: проблема и пути решения. Педиатрия. 2012; 91(4): 98–105.
Biagioli E., Tarasco V., Lingua C. et al. Pain-relieving agents for infantile colic. Cochrane Database Syst. Rev. 2016; 9(9). CD009999.
Katzer D., Pauli L., Mueller A. et al. Melatonin concentrations and antioxidative capacity of human breast milk according to gestational age and the time of day. J. Hum. Lact. 2016; 32(4): 105–10.
Kurtoglu S., Uzüm K., Hallac I.K., Coskum A. 5-Hydroxy-3-indole acetic acid levels in infantile colic: is serotoninergic tonus responsible for this problem? Acta Paediatr. 1997; 86(7): 764–5.
Anderson G., Vaillancourt C., Maes M., Reiter R.J. Breastfeeding and the gut-brain axis: is there a role for melatonin? Biomol. Concepts. 2017; 8(3-4): 185–95.
Богданова Н.М., Белова Е.М. Роль нейропептидов в генезе кишечных колик. Фарматека. 2019; 26(2): 89–92.
Savino F., Grassino E.C., Guidi C. et al. Ghrelin and motilin concentration in colicky infants. Acta Paediatr. 2006; 95(6): 738–41.
de Weerth C., Fuentes S., Puylaert P., de Vos W.M. Intestinal microbiota of infants with colic: development and specifi c signatures. Pediatrics. 2013; 131(2): 550–8.
Pärtty A., Kalliomäki M., Endo A., Salminen S., Isolauri E. Compositional development of Bifidobacterium and Lactobacillus microbiota is linked with crying and fussing in early infancy. PLoS One. 2012; 7(3). Article ID 32495.
Шаповалова Н.С., Новикова В.П. Ось кишечник–мозг и ее роль в развитии функциональных гастроинтестинальных расстройств. Children’s Medicine of the North-West. 2021; 9(4): 33–50.
Pärtty A., Kalliomäki M., Salminen S., Isolauri E. Infantile colic is associated with low-grade systemic inflammation. J. Pediatr. Gastroenterol. Nutr. 2017; 64(5): 691–5.
Новикова В.П., Магамедова Д.М., Блинов А.Е. и др. Моно- или мультипробиотики? Сравнительное клиническое исследование разных терапевтических стратегий при младенческих коликах. Медицинский совет. 2023; (17): 23–32. DOI: 10.21518/ms2023-313.
Savino F., Cresi F., Pautasso S. et al. Intestinal microflora in breastfed colicky and non-colicky infants. Acta Paediatr. 2004; 93: 825–9.
Savino F., Cordisco L., Tarasco V. et al. Molecular identification of coliform bacteria from colicky breastfed infants. Acta Paediatr. Int J Paediatr. 2009; 98(10): 1582–8. DOI: 10.1111/j.1651-2227.2009.01419.x.
Mentula S., Tuure T., Koskenala R. et al. Microbial composition and fecal fermentation end products from colicky infants — a probiotic supplementation pilot. Microb Ecol Health Dis. 2008; 20(1): 37–47.
de Weerth C., Fuentes S., Puylaert P., de Vos W.M. Intestinal microbiota of infants with colic: Development and specific signatures. Pediatrics. 2013; 131: e550–8. DOI: 10.1542/peds.2012-1449.
Rhoads J.M., Collins J., Fatheree N.Y. et al. Infant colic represents gut inflammation and dysbiosis. J Pediatr. 2018; 203: 55–61.e3. DOI: 10.1016/j.jpeds.2018.07.042.
Loughman A. et al. Infant microbiota in colic: Predictive associations with problem crying and subsequent child behavior. J. Dev. Orig. Health Dis. 2021; 12: 260–70. DOI: 10.1017/S2040174420000227.
Kozhakhmetov S., Meiirmanova Z., Mukhanbetzhanov N. et al. Compositional and functional variability of the gut microbiome in children with infantile colic. Sci Rep. 2023; 13(1): 9530. DOI: 10.1038/s41598-023-36641-z.
Savino F., Montanari P., Galliano I. et al. Lactobacillus rhamnosus GG (ATCC 53103) for the Management of Infantile Colic: A Randomized Controlled Trial. Nutrients. 2020; 12(6): 1693. DOI: 10.3390/nu12061693.
Savino F., Cordisco L., Tarasco V. et al. Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants. BMC Microbiol. 2011; 30(11): 157.
Corvaglia L., Tonti G., Martini S. et al. Influence of intrapartum antibiotic prophylaxis for group B Streptococcus on gut microbiota in the fi rst month of life. J. Pediatr. Gastroenterol. Nutr. 2016; 62(2): 304–8.
Lucassen P.L., Assendelft W.J., van Eijk J.T. et al. Systematic review of the occurrence of infantile colic in the community. Arch. Dis. Child. 2001; 84(5): 398–403.
Rhoads J.M., Fatheree N.Y., Norori J. et al. Altered fecal microfl ora and increased fecal calprotectin in infants with colic. J. Pediatr. 2009; 155(6): 823–8.e1.
Hofmann A.F. Enterohepatic Circulation of Bile Acids. Comprehensive Physiology. USA: John Wiley and Sons. 2011: 567–96.
Sarasu J.M., Narang M., Shah D. Infantile Colic: An Update. Indian Pediatr. 2018; 55(11): 979–87. Epub 2018 Jun 13. PMID: 29941700.
Титова О.Н., Таран Н.Н. Кишечные колики у детей первых месяцев жизни: комплексное решение проблемы. Педиатрия. Прил. к журн. МConsilium Medicum. 2018; 1: 90–3. DOI: 10.26442/2413-8460_2018.1.90-93.
Савино Ф., Захарова И.Н., Боровик Т.Э. и др. Новые данные о лечении кишечных колик у младенцев. Вопр. соврем. педиатрии. 2015; 14(5): 553–6.
Zeskind P.S., Barr R.G. Acoustic characteristics of naturally occurring cries of infants with “colic”. Child Dev. 1997; 68: 394–403.
Merkel S.I., Voepel-Lewis T., Shayevitz J.R., Malviya S. The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997; 23: 293–7.
UK NICE. Clinical Knowledge Summary Infant Colic 2017 and Postnatal care: routine postnatal care of women and their babies (NICE Guideline, 2015). Available at: https://www.nice.org.uk.
Ireland: Irish College of General Practitioners. Available at: https://www.icgp.ie.
Бельмер С.В., Разумовский А.Ю., Хавкин А.И., ред. Детская гастроэнтерология. Национальное руководство. М.: ГЭОТАР-Медиа; 2022.
Бельмер С.В., Волынец Г.В., Горелов А.В. и др. Функциональные расстройства органов пищеварения у детей. Рекомендации Общества детских гастроэнтерологов, гепатологов и нутрициологов. Часть 2. Российский вестник перинатологии и педиатрии. 2020; 65(5): 100–11. DOI: 10.21508/1027-4065-2020-65-5-100-111.
Cohen Engler A., Hadash A., Shehadeh N., Pillar G. Breastfeeding may improve nocturnal sleep and reduce infantile colic: potential role of breast milk melatonin. Eur. J. Pediatr. 2012; 171(4): 729–32.
Dumbell R., Matveeva O., Oster H. Circadian clocks, stress, and immunity. Front. Endocrinol. Lausanne. 2016; 2(7): 37.
van Tilburg M.A.L., Hyman P.E., Walker L. et al. Prevalence of functional gastrointestinal disorders in infants and toddlers. J Pediatr. 2015; 166(3): 684–9. DOI: 10.1016/j. jpeds.2014.11.039.
Hill D.J., Roy N., Heine R.G. et al. Effect of a low-allergen maternal diet on colic among breastfed infants: a randomized, controlled trial. Pediatrics. 2005; 116(5): 709–15.
Gordon M., Biagioli E., Sorrenti M. et al. Dietary modifications for infantile colic. Cochrane Database Syst. Rev. 2018; 10(10). CD011029.
Harb T., Matsuyama M., David M., Hill R.J. Infant colic-what works: a systematic review of interventions for breast-fed infants. J. Pediatr. Gastroenterol. Nutr. 2016; 62(5): 668–86.
Hizli S., Can D., Kiliç I. et al. Diagnosis and Treatment Approaches in Infantile Colic (IC): Results of a Survey Among Paediatricians in Turkey. Front Pediatr. 2021; 9: 779997. DOI: 10.3389/fped.2021.779997.
Lacovou M., Ralston R.A., Muir J. et al. Dietary management of infantile colic: a systematic review. Matern. Child Health J. 2012; 16(6): 1319–31.
Hofmann A.F. Enterohepatic Circulation of Bile Acids. Comprehensive Physiology. USA: John Wiley and Sons. 2011: 567–96.
Новикова В.П., Магамедова Д.М. Пробиотические свойства штаммов lactobacillus reuteri (L. reuteri). Children’s medicine of the North-West. 2023; 11(3): 36–5. DOI 10.56871/CmN-W.2023.75.34.002.
Garcia Rodenas C.L., Lepage M., Ngom-Bru C. et al. Effect of Formula Containing Lactobacillus reuteri DSM 17938 on Fecal Microbiota of Infants Born by Cesarean-Section. J Pediatr Gastroenterol Nutr. 2016; 63(6): 681–7. DOI: 10.1097/MPG.0000000000001198.
Jones M.L., Martoni C.J., Prakash S. Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. J Clin Endocrinol Metab. 2013; 98(7): 2944–51. DOI: 10.1210/jc.2012-4262.
Savino F., Galliano I., Savino A. et al. Lactobacillus reuteri DSM 17938 Probiotics May Increase CC-Chemokine Receptor 7 Expression in Infants Treated With for Colic. Front. Pediatr. 2019; 7: 292. DOI: 10.3389/fped.2019.00292.
Hojsak I. Probiotics in functional gastrointestinal disorders. Adv. Exp. Med. Biol. 2019; 1125, 121–37. DOI: 10.1007/5584_2018_321.
Pourmirzaiee M.A., Famouri F., Moazeni W. et al. The efficacy of the prenatal administration of Lactobacillus reuteri LR92 DSM 26866 on the prevention of infantile colic: a randomized control trial. Eur. J. Pediatr. 2020; 179: 1619–26. DOI: 10.1007/s00431-020-03641-4.
Sheldon J.M., Alonso N. The Therapeutic Benefits of Single and Multi-Strain Probiotics on Mean Daily Crying Time and Key Inflammatory Markers in Infantile Colic. Cureus. 2022; 14(8): e28363. DOI: 10.7759/cureus.28363.
Savino F., Pelle E., Palumeri E. et al. Lactobacillus reuteri (American Type Culture Collection Strain 55730) simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics. 2007; 119: e124–30. DOI: 10.1542/peds.2006-1222.
Szajewska H., Dryl R. Probiotics for the Management of Infantile Colic. J Pediatr Gastroenterol Nutr. 2016; 63(Suppl 1): S22–4. DOI: 10.1097/MPG.0000000000001220.
Chau K., Lau E., Greenberg S. et al. Probiotics for infantile colic: a randomized, double-blind, placebo-controlled trial investigating Lactobacillus reuteri DSM 17938. J Pediatr. 2015; 166(1): 74–8. DOI: 10.1016/j.jpeds.2014.09.020.
Mi G.L., Zhao L., Qiao D.D. et al. Effectiveness of Lactobacillus reuteri in infantile colic and colicky induced maternal depression: a prospective single blind randomized trial. Antonie Van Leeuwenhoek. 2015; 107(6): 1547–53. DOI: 10.1007/s10482-015-0448-9.
Tatari M., Yazdani Charati J., Karami H., Rouhanizadeh H. Effect of Probiotics on Infantile Colic Using the Quadratic Inference Functions. Iranian Journal of Neonatology. 2017; 8(3). DOI: 10.22038/ijn.2017.19901.1225.
Dryl R., Szajewska H. Probiotics for management of infantile colic: a systematic review of randomized controlled trials. Arch Med Sci. 2018; 14(5): 1137–43. DOI: 10.5114/aoms.2017.66055.
Sung V., Hiscock H., Tang M.L. et al. Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ. 2014; 348: g2107.
Fatheree N.Y., Liu Y., Taylor C.M. et al. Lactobacillus reuteri for Infants with Colic: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial. J Pediatr. 2017; 191: 170–8.e2. DOI: 10.1016/j.jpeds.2017.07.036.
Xinias I., Analitis A., Mavroudi A. et al. Innovative Dietary Intervention Answers to Baby Colic. Pediatr Gastroenterol Hepatol Nutr. 2017; 20(2): 100–6. DOI: 10.5223/pghn.2017.20.2.100.
Nocerino R., De Filippis F., Cecere G. et al. The therapeutic efficacy of Bifidobacterium animalis subsp. lactis BB-12® in infant colic: A randomised, double blind, placebo-controlled trial. Aliment Pharmacol Ther. 2020; 51(1): 110–20. DOI: 10.1111/apt.15561.
Chen K., Zhang G., Xie H. et al. Efficacy of Bifidobacterium animalis subsp. lactis, BB-12® on infant colic – a randomised, double-blinded, placebo-controlled study. Benef Microbes. 2021; 12(6): 531–40. DOI: 10.3920/BM2020.0233.
Suanes-Cabello A. Efficacy of Bifidobacterium breve CECT7263 for infantile colic treatment: an open-label, parallel, randomised, controlled trial. Beneficial Microbes. 2020: 1–14. DOI: 10.3920/bm2020.0105.
Kwoji I.D., Aiyegoro O.A., Okpeku M., Adeleke M.A. Multi-Strain Probiotics: Synergy among Isolates Enhances Biological Activities. Biology (Basel). 2021; 10(4): 322. DOI: 10.3390/biology10040322.
Gerasimov S., Gantzel J., Dementieva N. et al. Role of Lactobacillus rhamnosus (FloraActive™) 19070-2 and Lactobacillus reuteri (FloraActive™) 12246 in infant colic: a randomized dietary study. Nutrients. 2018; 10(12): 1975. DOI: 10.3390/nu10121975.
Baldassarre M.E., Di Mauro A., Tafuri S. et al. Effectiveness and safety of a probiotic-mixture for the treatmen of infantile colic: a double-blind, randomized, placebo-controlled clinical trial with fecal real-time PCR and NMR-based metabolomics analysis. Nutrients. 2018; 10(2): 195. DOI: 10.3390/nu10020195.
Astó E., Huedo P., Altadill T. et al. Probiotic Properties of Bifidobacterium longum KABP042 and Pediococcus pentosaceus KABP041 Show Potential to Counteract Functional Gastrointestinal Disorders in an Observational Pilot Trial in Infants. Front Microbiol. 2022; 12: 741391. DOI: 10.3389/fmicb.2021.741391.
Biagioli E., Tarasco V., Lingua C. et al. Pain-relieving agents for infantile colic. Cochrane Database Syst. Rev. 2016; 9(9). CD009999.
Ellwood J., Draper-Rodi J., Carnes D. Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines. BMJ Open. 2020; 10(2). Article ID 035405.
Vandenplas Y., Benninga M., Broekaert I. et al. Functional gastro-intestinal disorder algorithms focus on early recognition, parental reassurance and nutritional strategies. Acta Paediatr. 2016; 105(3): 244–52. DOI: 10.1111/apa.13270.
