Disorders of gut-brain interactions (functional gastrointestinal disorders)
Disorders of Gut-Brain Interactions (DGBIs) is a recent term that includes a variety of common conditions in children (and adults).1 The term DGBI replaced the previous term of Functional Gastrointestinal Disorders (FGIDs) when the Rome IV criteria was published in 2016.1,2 The pathophysiology of these gastrointestinal (GI) disorders is complex, involving two way dysregulation of gut-brain interaction, microbial dysbiosis within the infant gut, altered gut immune function, gut hypersensitivity and abnormal gastrointestinal motility.3
DGBIs are defined as variable combinations of chronic or recurrent gastrointestinal (GI) signs and symptoms without obvious structural or biochemical alterations.2 It is thought that they affect up to 50% of infants.4,5 DGBIs can be a real concern and cause of stress in families, even though they are mostly benign.
The most common early childhood DGBIs are:
- Regurgitation
- Colic
- Functional constipation
There are diagnostic criteria2, algorithms6 and clinical guidelines7 available which have been developed to guide and inform practical management by Healthcare Professionals.
The first line treatments consist of:
- Parental support
- Parental reassurance
- Nutritional advice
DGBIs are a frequent cause of parental anxiety, as well as repeated healthcare professional consultations.8 In 2014-2015 the total estimated cost of these gastrointestinal conditions was £72.3 million, of which £49.1 million were NHS costs and £23.2 were costs incurred by parents.9 These figures did not include the cost of alternative therapies, in-patient treatments, diagnostic tests and parents time off work, making the actual costs substantially higher.
Given the impact both on families and healthcare, primary management of infant DGBIs should focus on improvement of symptoms and family quality of life. If additional support beyond parental reassurance is required, existing evidence suggests that nutritional advice is a beneficial approach.8
- Rome Foundation. What is a Disorder of Gut-Brain Interaction (DGBI)? Available at https://theromefoundation.org/what-is-a-disorder-of-gut-brain-interaction-dgbi/ Accessed July 2025.
- Benninga MA. et al. Childhood functional gastrointestinal disorders: Neonate/toddler. Gastroenterology 2016;150:1443–55.
- Black C.J. Functional gastrointestinal disorders: advances in understanding and management. Lancet 2020;396:1664-74.
- Iacono G. et al. Gastrointestinal symptoms in infancy: a population-based prospective study. Dig Liver Dis 2005;37:432–8.
- Vandenplas Y, Abkari A, Bellaiche M, et al. Prevalence and Health Outcomes of Functional Gastrointestinal Symptoms in Infants from birth to 12 months of age. JPGN 2015;61:531–7.
- Vandenplas Y, Alarcon P. Updated algorithms for managing frequent gastro-intestinal symptoms in infants. Benef Microbes 2015;6(2):199-208.
- NICE (2015). Gastro-oesophageal reflux disease in children and young people. Available at https://www.nice.org.uk/guidance/ng1. Accessed: July 2025.
- 8. Vandenplas Y, et al. Functional Gastrointestinal Disorders in Infancy: Impact on the health of the Infant and Family. JPGN 2019:22:207-216.
- Mahon J. et al. The costs of functional gastrointestinal disorders and related signs and symptoms in infants: a systematic literature review and cost calculation for England. BMJ 2017; Vol 7, Issue 11. Available at https://bmjopen.bmj.com/content/7/11/e015594 (Accessed July 2025).