July 2, 2012 — Helicobacter pylori infection was strongly associated with infantile colic in a small case control study. The study was published in the July issue of Archives of Pediatrics & Adolescent Medicine. "Numerous studies have elucidated the pathogenesis, immunology, and H pylori gastrointestinal–related disorders (in addition to extraintestinal manifestations) associated with H pylori infection, but to my knowledge, none of these studies have investigated the role of H pylori in infantile colic," writes author Abdelrazak Mansour Ali, MD, from the Department of Pediatrics, at Al-Azhar University, Cairo, Egypt.
The cause of infantile colic remains unknown, despite being relatively common. Its prevalence ranges from 5% to 40%, depending on estimates.
As part of an effort to understand the pathogenesis of various infantile disorders with unclear origins, Dr. Ali investigated the potential role of H pylori infection in infantile colic.
He enrolled 55 infants with the disorder, each 2 to 4 weeks old, in the study. All infants had been seen for routine clinical care, vaccination, or other medical services at an outpatient clinic in rural Saudi Arabia from May to September 2009. All met established criteria for infantile colic, being otherwise well, thriving infants who had cried for 3 hours each day more than 3 days each week for longer than 3 weeks.
Other potential causes of distress, including central nervous system abnormalities, broken bones or other trauma, infections, foreign bodies in the eye, and gastrointestinal problems other than colic, were ruled out.
Dr. Ali enrolled a cohort of 30 control infants from the same population, who were matched by nationality, age, sex, and race. A total of 28 boys and 27 girls were included in the case group, 17 boys and 13 girls in the control group.
He used a stool antigen test to check for the presence of H pylori in both case and control groups. He also administered questionnaires to the mothers to ask, among other things, about maternal health status and about how often the baby cried and for how long.Of the 55 case infants, 45 (81.8%) tested positive for H pylori, and 10 (18.2%) tested negative. Among the 30 infants in the control group, however, only 7 (23.3%) tested positive for H pylori, and 23 (76.7%) tested negative (odds ratio, 15.3; 95% confidence interval [CI], 7.9 - 29.8).
This is not the first study to implicate H pylori as a possible factor in infantile colic. Some recent studies have suggested that a daily dose of probiotics may improve colic symptoms.
Dr. Ali says that based on his results, along with those from previous studies, "Helicobacter pylori infections may be considered the etiologic pathogenic organism of infantile colic."
The author has declared no relevant financial relationships.
Arch Pediatr Adolesc Med. 2012;166(7):648-650.
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