Hizli Samil, Can Demet, Kiliç Ilknur, Örün Emel, Tunç Turan, Özkan Hasan
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Ankara Yildirim Beyazit University, Ankara, Turkey.
Division of Pediatric Allergy and Immunology, Balikesir University, Balikesir, Turkey.
Front Pediatr. 2021 Dec 23;9:779997. doi: 10.3389/fped.2021.779997. eCollection 2021.
Due to limited knowledge on the etiopathogenesis of infantile colic (IC) and the insufficiency of data regarding current treatments, different approaches emerge in terms of diagnosis, and treatment modalities globally and also in Turkey. The objective of this study was to observe how infantile colic is diagnosed and treated by paediatricians in Turkey. An anonymous electronic questionnaire was used to collect the respondents' opinions. The study questionnaire was comprised of 4 different sections with 56 multiple-choice questions covering demographic features, diagnostic approach, treatment preferences and response to treatment. A total of 375 paediatricians responded to the survey. Fifty three percent of the participants stated that they established the IC diagnosis based only on their clinical experience. Factors that most affected the decision to start treatment were identified as parent discomfort, decreased family quality of life, and crying duration (68, 66, and 54%, respectively). Application of soothing methods, probiotics, and simethicone were identified as the most frequently used treatment modalities (frequency ranking; 81, 76, and 50%, respectively). Of the participants, 98% stated that they used probiotic as supplements, on the other hand, 72% of the participants indicated that they used simethicone as the only medical treatment to treat IC. The question about the participants' observations regarding the response to probiotic treatment was answered by 71% of the participants with decreased crying duration, while easier stool/gas passage and resolved digestion problems were the other frequent observations (54 and 49%, respectively). The observations related to the response to simethicone treatment also included decreased crying duration in addition to decreased crying periods after feeding and easier gas/stool passage (67, 47, and 44%, respectively). Survey results revealed that the majority of the paediatricians used their clinical experience alone to establish the diagnosis of IC and preferred probiotic supplements and simethicone as the only medical treatment to treat IC and they observed clinical benefits from them. Insights generated by this study will be helpful to guide future efforts to improve the management of infantile colic by paediatricians.
由于对婴儿腹绞痛（IC）的病因发病机制了解有限，且当前治疗的数据不足，全球范围内以及土耳其在诊断和治疗方式上出现了不同的方法。本研究的目的是观察土耳其儿科医生如何诊断和治疗婴儿腹绞痛。使用匿名电子问卷收集受访者的意见。研究问卷由4个不同部分组成，有56个多项选择题，涵盖人口统计学特征、诊断方法、治疗偏好和对治疗的反应。共有375名儿科医生回复了调查。53%的参与者表示他们仅根据临床经验做出IC诊断。最影响开始治疗决策的因素被确定为家长的不适、家庭生活质量下降和哭闹持续时间（分别为68%、66%和54%）。安抚方法、益生菌和西甲硅油的应用被确定为最常用的治疗方式（频率排名分别为81%、76%和50%）。在参与者中，98%表示他们使用益生菌作为补充剂，另一方面，72%的参与者表示他们使用西甲硅油作为治疗IC的唯一药物治疗。71%的参与者回答了关于他们对益生菌治疗反应的观察问题，其中哭闹持续时间减少，而大便/气体排出更容易和消化问题得到解决是其他常见的观察结果（分别为54%和49%）。与西甲硅油治疗反应相关观察结果还包括哭闹持续时间减少，此外还有喂食后哭闹时间减少和气体/大便排出更容易（分别为67%、47%和44%）。调查结果显示，大多数儿科医生仅依靠临床经验来诊断IC，并且更喜欢将益生菌补充剂和西甲硅油作为治疗IC的唯一药物治疗，他们观察到了这些治疗带来的临床益处。本研究产生的见解将有助于指导未来儿科医生改善婴儿腹绞痛管理的工作。
