Feeding problems and gastrointestinal diseases in Down syndrome

Area of Science:

• Gastroenterology
• Genetics
• Pediatrics

Background:

• Feeding problems and gastrointestinal disorders are prevalent in individuals with Down syndrome (DS).
• These conditions significantly impact the daily lives and overall health of people with DS.
• A comprehensive understanding of these anomalies is crucial for effective management.

Purpose of the Study:

• To systematically review and categorize the spectrum of gastrointestinal and feeding-related anomalies in individuals with Down syndrome.
• To provide a reference for clinicians and researchers on the prevalence and types of these conditions.
• To inform clinical practice regarding diagnosis, management, and screening.

Main Methods:

• A comprehensive literature search was conducted on PubMed in October 2018.
• The search focused on identifying studies related to feeding problems and gastrointestinal disorders in Down syndrome.
• A total of 504 references were selected and analyzed.

Main Results:

• Anomalies were categorized into anatomical (e.g., duodenal atresia, Hirschsprung's disease, orofacial clefts), biological/immunological/infectious (e.g., neonatal cholestasis, Helicobacter pylori infection, celiac disease, NAFLD), and functional (e.g., swallowing disorders, GERD, obesity, constipation).
• Specific prevalence rates were noted for various conditions, such as orofacial clefts (4.63%), H. pylori infection (up to 75.8% in institutionalized individuals), and NAFLD (82% in obese individuals).
• Key clinical recommendations include early speech therapy, systematic abdominal ultrasounds, vitamin D supplementation, H. pylori screening in institutionalized individuals, and hepatitis B vaccination.

Conclusions:

• Individuals with Down syndrome exhibit a wide range of gastrointestinal and feeding-related anomalies that require vigilant monitoring and management.
• Early detection, timely intervention, and tailored support are essential for improving the quality of life for people with DS.
• Further research and standardized screening protocols are needed to optimize care for these complex conditions.