Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università di Torino, Ospedale Infantile Regina Margherita - Città della Salute e della Scienza di Torino, Turin, Italy.
Ital J Pediatr. 2014 Jun 5;40:53. doi: 10.1186/1824-7288-40-53.
Infantile colic is a common disturbance occurring in the first three months of life. It is a benign condition and one of the main causes of pediatric consultation in the early part of life because of its great impact on family life. Some pediatricians are prone to undervalue this issue mainly because of the lack of evidence based medicine guidelines. Up to now, there is no consensus concerning management and treatment. Literature reports growing evidence about the effectiveness of dietary, pharmacological, complementary and behavioral therapies as options for the management of infantile colic. Dietary approach, usually based on the avoidance of cow's milk proteins in breast-feeding mothers and bottle-fed infants, more recently has seen the rise of new special formulas, such as partially hydrolyzed proteins and low lactose added with prebiotics or probiotics: their efficacy needs to be further documented. Investigated pharmacological agents are Simethicone and Cimetropium Bromide: the first is able to reduce bloating while the second could reduce fussing crying, but it has been tested only for severe infantile colic. No other pain relieving agents have been proposed until now, but some clinical trials are ongoing for new drugs.There is limited evidence supporting the use of complementary and alternative treatments (herbal supplements, manipulative approach and acupuncture) or behavioral interventions.Recent studies have focused the role of microbiota in the pathogenesis of this disturb and so new treatments, such as probiotics, have been proposed, but only few strains have been tested.Further investigations are needed in order to provide evidence-based guidelines.
婴儿肠绞痛是一种常见于生命头三个月的紊乱。它是一种良性病症,也是生命早期小儿科就诊的主要原因之一,因为它对家庭生活有很大影响。一些儿科医生倾向于低估这个问题,主要是因为缺乏循证医学指南。到目前为止,对于婴儿肠绞痛的管理和治疗还没有共识。文献报道越来越多的关于饮食、药理、补充和行为疗法的有效性的证据,这些都是管理婴儿肠绞痛的选择。饮食方法,通常基于母乳喂养的母亲和奶瓶喂养婴儿避免牛奶蛋白,最近出现了新的特殊配方,如部分水解蛋白和添加低乳糖的益生元或益生菌:它们的疗效需要进一步证明。研究的药物是西甲硅油和西米替丁溴化物:前者能够减少腹胀,而后者可以减少哭闹,但只在严重的婴儿肠绞痛中进行了测试。到目前为止,还没有提出其他的止痛药物,但一些临床试验正在进行新药物的研究。有有限的证据支持补充和替代治疗(草药补充剂、推拿和针灸)或行为干预的使用。最近的研究集中在微生物群在这种紊乱发病机制中的作用,因此提出了新的治疗方法,如益生菌,但只有少数菌株进行了测试。为了提供循证指南,还需要进一步的研究。