What gastrointestinal factors could contribute to infantile colic?

    Last Updated: October 25, 2023

    One theory is that gastroesophageal reflux disorder (GERD) causes colic, but there is inconsistent evidence for this, and treatments for GERD are ineffective for reducing colic.[1][2][3] Hypersensitivity to cow’s milk, lactose intolerance, and reactions to allergens in breast milk from the mothers diet may be responsible for colic in some infants. This follows from the observation that exclusive use of hypoallergenic formula and/or maternal elimination diets may benefit colic in some cases. However, evidence for this is inconsistent.[4][5][6][7][8][3][9] The evidence that these factors contribute to colic is stronger where there are atopic conditions present, such as eczema or psoriasis, and when symptoms of colic start after the first month of life.[4]
    Immature synthesis and malabsorption of bile acids (which help to digest and absorb fats) may lead to the presence of fats and other nutrients in the large intestine. This may contribute to colic by influencing the bacteria in the large intestine consuming these nutrients and producing gas.[10]

    References

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    2. ^Di Lorenzo, COther Functional Gastrointestinal Disorders in Infants and Young ChildrenPediatric Gastroenterology and Nutrition.(December 2013)
    3. ^Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko SChildhood Functional Gastrointestinal Disorders: Neonate/Toddler.Gastroenterology.(2016-Feb-15)
    4. ^Gordon M, Biagioli E, Sorrenti M, Lingua C, Moja L, Banks SS, Ceratto S, Savino FDietary modifications for infantile colic.Cochrane Database Syst Rev.(2018-Oct-10)
    5. ^Nocerino R, Pezzella V, Cosenza L, Amoroso A, Di Scala C, Amato F, Iacono G, Canani RBThe controversial role of food allergy in infantile colic: evidence and clinical management.Nutrients.(2015-Mar-19)
    6. ^Fiocchi A, Brozek J, Schünemann H, Bahna SL, von Berg A, Beyer K, Bozzola M, Bradsher J, Compalati E, Ebisawa M, Guzman MA, Li H, Heine RG, Keith P, Lack G, Landi M, Martelli A, Rancé F, Sampson H, Stein A, Terracciano L, Vieths SWorld Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines.World Allergy Organ J.(2010-Apr)
    7. ^Biagioli E, Tarasco V, Lingua C, Moja L, Savino FPain-relieving agents for infantile colic.Cochrane Database Syst Rev.(2016-Sep-16)
    8. ^Ralf G HeineGastroesophageal reflux disease, colic and constipation in infants with food allergyCurr Opin Allergy Clin Immunol.(2006 Jun)
    9. ^Merras-Salmio L, Pelkonen AS, Kolho KL, Kuitunen M, Mäkelä MJCow's milk-associated gastrointestinal symptoms evaluated using the double-blind, placebo-controlled food challenge.J Pediatr Gastroenterol Nutr.(2013-Sep)
    10. ^Camilleri M, Park SY, Scarpato E, Staiano AExploring hypotheses and rationale for causes of infantile colic.Neurogastroenterol Motil.(2017-Feb)