0926 Is there a relationship between colic and gut colonization?

For parents and paediatricians alike there is little that is more frustrating than being presented with a persistently colicky infant. While far from life-threatening, colic remains as a challenge to parenthood and paediatric care. Available evidence suggests that the condition has several independent possible causes such as food allergy or hypersensitivity, immaturity of gut function, and dysmotility. Excessive intestinal gas production has also been linked, but little is known about the bowel bacteria that could cause intra-intestinal air load. Specific research into gut colonization has been the focus of research for a couple of European groups over the past 10-15 years with one coining the term ‘dismicrobism,’ implying that colic is the result of impaired or dysfunctional colonization. Hypotheses to explain the colicky symptoms include abundance of one species decreasing the presence of beneficial bacteria, reduced induction of T cells by beneficial bacteria, and immune dysregulation involving impaired production of cytokines by antigen-presenting cells, thereby affecting T-cell differentiation and intestinal permeability. Most of the latter remain speculative and the microbial studies are confusing and contradictory. For example one study has shown that Clostridium difficile colonization was more frequent in colicky infants; another showed that the Lactobacillus species was important with acidophilus being beneficial and brevis and lactis being associated with colic, and a recent study from the same group as in the latter study found E coli to be the villain in colicky infants. Clearly there is much to be done before one can begin to target a specific organism, but perhaps note should be taken of a randomized controlled study that compared Lactobacillus reuteri to simethicone in the treatment of colic. This probiotic had an impressive effect such that after 28 days 95% were responders vs only 7% in the simethicone group. Given the prevalence of colic and the benign nature of a probiotic, this avenue appears to be worthy of further research

Read more:
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