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Early-Life Events and the Prevalence of Gut-Brain Interaction Disorders in Children
Atchariya Chanpong1, Natchayada Ponjorn2, Nattaporn Tassanakijpanich3
1Division of Gastroenterology and Hepatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Insights
Disorders of gut-brain interaction (DGBI) are common in young children, especially girls. Exclusive breastfeeding for at least three months significantly protects against DGBI development.
Area of Science:
- Pediatric Gastroenterology
- Microbiome Research
- Neurogastroenterology
Background:
- Disorders of gut-brain interaction (DGBI) involve chronic gastrointestinal symptoms linked to microbiota-gut-brain axis dysregulation.
- Early-life events are critical influencers of the microbiota-gut-brain axis development.
- Understanding DGBI prevalence and risk factors in early childhood is essential.
Purpose of the Study:
- To determine the prevalence of DGBI in 3-year-old children.
- To investigate the association between DGBI and early-life events.
- To identify protective factors against DGBI in early childhood.
Main Methods:
- Prospective follow-up of 568 children from 2 months to 3 years of age.
- GI symptom assessment during routine clinic visits using ROME IV criteria for DGBI diagnosis.
- Collection of demographic data and early-life factors, including feeding practices and medication exposure.
Main Results:
- A DGBI prevalence of 24.5% was observed in 3-year-old children, with functional constipation being the most common diagnosis.
- DGBI prevalence was significantly higher in girls (28.1%) compared to boys (20.7%).
- Exclusive breastfeeding for ≥3 months was identified as a significant protective factor against DGBI.
Conclusions:
- Sex is a significant factor influencing DGBI prevalence in children up to 3 years old.
- Breastfeeding, particularly exclusive breastfeeding for at least three months, provides the most effective protection against DGBI development.
- Early-life interventions focusing on breastfeeding may mitigate the risk of DGBI in children.
Abstract:
Background/Objectives: Disorders of gut-brain interaction (DGBI) include a spectrum of disorders with chronic/recurrent gastrointestinal symptoms, caused by dysregulation of microbiota-gut-brain interaction. Early-life events have been suggested as the main factors influencing the microbiota-gut-brain axis. We aimed to evaluate the prevalence of DGBI in 3-year-old children and its relationship with early-life events. Methods: The parents of children aged 3 years, who had been followed up in a well-baby clinic since they were 2 months old, were asked about any GI symptoms their child had experienced during the check-up visits between September 2023 and June 2024. The final diagnosis of DGBI was based on ROME IV criteria. Demographic data, including early-life factors, were collected. Results: Overall, 568 children (48.6% boys) were included, of whom 139 (24.5%) had symptoms consistent with at least one DGBI diagnosis. The most prevalent DGBI was functional constipation (20.4%), followed by colic (4.6%), infant regurgitation (2.8%), and dyschezia (1.6%). Approximately 48% of the children were breastfed for ≥6 months, and 21% were exposed to ≥1 antibiotic/antiviral drugs in the first year of life. DGBI prevalence was significantly higher in girls than in boys (28.1% vs. 20.7%; p = 0.041). Exclusive breastfeeding was the most significant protective factor against DGBI, particularly if performed for ≥3 months. Conclusions: Sex was the most significant factor affecting DGBI prevalence in children aged ≤3 years; breastfeeding offers the most effective protection against DGBI development.
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