Медицинский совет (Mar 2020)
Childhood functional gastrointestinal disorders: rational therapy
Abstract
Introduction. Gastrointestinal dysfunctions remain one of the most frequent problems in young children (0 to 2 years). Among the main causes are immaturity of the enzymatic system, morphology and function of the gastrointestinal tract, regulatory mechanisms of the nervous system, immune response. The composition of intestinal microflora in children in the first years of life is unstable and can easily change under the influence of unfavorable factors: feeding disorders, infectious pathogens, congenital defects, incomplete immunity. Modern scientific literature and clinical guidelines most accurately reflect the results of studies on the positive role of probiotics, for example, in the prevention and treatment of antibiotic-associated diarrhoea and acute diarrhoea of various genesis. The research base is so large that in 2012 the World Gastroenterology Organization developed an international practical guide to the use of probiotics in clinical practice, recommending the use of probiotics that meet certain criteria.The review is devoted to evaluating the effectiveness and safety of treatment with probiotics containing Bifidobacterium lactis, BB-12 and Streptococcus thermophilus TH-4 in children aged 0 to 2 years. Data from meta-analyses of the Cochrane library, PubMed, EMBASE, CENTRAL, and Russian open clinical randomized, placebo-controlled studies on the use of probiotics containing Bifidobacterium lactis, BB-12, and Streptococcus thermophilus TH-4 in pediatric practice are presented. Study objective. A comparative description of the most popular commercial drugs used for the treatment and prevention of functional disorders of the gastrointestinal tract in children aged 0 to 2 years, containing at least one of these strains, is presented.Results. Evidence of the significance of probiotic therapy for various disorders of the gastrointestinal tract in children aged 0 to 2 years with complex drugs containing a combination of Bifidobacterium lactis, BB-12 and Streptococcus thermophilus TH-4 strains in children aged 0 to 2 years is presented. There is no reliable evidence of the effectiveness of multi-strain drug combinations in this age group.Conclusion. The combination of Bifidobacterium lactis, BB-12 and Streptococcus thermophilus TH-4 is an effective and safe combination for the treatment of gastrointestinal disorders in children aged 0 to 2 years.
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