Functional gastrointestinal disorders (FGID), such as infant regurgitation, infant colic, and functional constipation, are common and typically physiological phenomena during the early months of an infant's life and account for frequent consultations with pediatricians. Various infant formulas are marketed for their management and are frequently given by parents to infants before a medical consultation. However, the evidence supporting their effectiveness is limited and some have altered nutritional compositions when compared to standard formulas. Thus, these products should only be used under medical supervision and upon medical advice. Marketing and over-the-counter sales do not ensure proper medical guidance and supervision. The aim of this position paper is to review the current evidence regarding the safety and efficacy of formulas specifically formulated for addressing regurgitation, colic, and constipation, recognized as FGID. The objective is to provide guidance for clinical management based on the highest quality of available evidence. A wide search using Pubmed, MEDLINE, EMBASE and Cochrane Database of Systematic Reviews was performed including the MESH terms infant formula, colic, constipation, regurgitation, reflux, palmitate, lactase, lactose, magnesium, hydrolyzed protein, prebiotics or probiotics. 752 papers were identified and screened. Finally, 72 papers were included in the paper. In the absence of evidence, recommendations reflect the authors' combined expert opinion. Final consensus was obtained by multiple e-mail exchange and meetings of the Nutrition Committee. (1) For breastfed infants experiencing FGID such as regurgitation, colic, or constipation, transitioning from breastfeeding to commercial formulas is not recommended. (2) In general, whether an infant is breastfed or formula-fed, it's crucial to reassure parents that FGIDs are normal and typically do not necessitate treatment or change to a special formula. (3) Thickened formulas, often termed anti-reflux formulas, may be considered in specific cases of regurgitation. (4) The usage of specialized formulas for infants with colic is not advised due to a lack of clinical evidence. (5) In the case of constipation in infants, the use of formulas enriched with high β-palmitate and increased magnesium content may be considered to soften the stool. Generally, there is limited evidence supporting the use of specialized formulas for FGID. Breastfeeding should never be discontinued in favor of formula feeding.

• Klíčová slova
• FGID, constipation, infant colic, regurgitation,
• MeSH
• gastrointestinální nemoci * terapie   MeSH
• kojenec MeSH
• kolika terapie   MeSH
• lidé MeSH
• náhražky mateřského mléka * MeSH
• novorozenec MeSH
• zácpa terapie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• směrnice pro lékařskou praxi MeSH

INTRODUCTION: High resolution anorectal manometry (HRAM) is a diagnostic method indicated in patients with anorectal dysfunction. The aim of the study was to evaluate the prevalence of anorectal dysfunctions and to assess therapeutic consequences. METHODS: Retrospective data of consecutive patients referred to HRAM in the period from March 2019 to February 2021 were evaluated. Basic manometric parameters were assessed: resting pressure (RP), maximal squeeze pressure (SP), rectal sensitivity (RS), and dyssynergic defecation (DD). RESULTS: 113 patients with combined fecal incontinence and obstructive defecation syndrome (FI + ODS: 44.2%), fecal incontinence (FI: 26.5%), obstructive defecation syndrome (ODS: 16.8 %), stoma before restoration of intestinal continuity (6.2%), functional pelvic pain (FP: 3.5 %) and controversial cases (2.7%) were analyzed. The average age was 54 years; female patients predominated (72 %). Patients with FI and FI+ODS had lower mean RP (57 mmHg and 53 mmHg) and/or lower SP (160 mmHg and 140 mmHg) compared to baseline. Patients with ODS had normal values of mean RP (75 mmHg) and SP (225 mmHg). DD was noted in most patients (FI: 76.6%, FI + ODS: 88%, ODS: 89.5%, FP: 100%). Conservative therapy with pelvic floor physiotherapy was provided in most cases (FI+ODS: 40%, ODS: 36.8%, FI: 13.3%, FP: 75%). CONCLUSION: In patients with defecation disorders there is a high prevalence of pathological manometric findings that combine with each other. Based on manometric findings, conservative treatment with individual pelvic floor physiotherapy can be initiated.

• Klíčová slova
• anorectal dysfunction, anorectal manometry, pelvic floor physiotherapy,
• MeSH
• anální kanál * MeSH
• defekace MeSH
• fekální inkontinence * diagnóza   epidemiologie   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• manometrie MeSH
• rektum MeSH
• retrospektivní studie MeSH
• zácpa diagnóza   epidemiologie   terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Patients with intractable chronic constipation should be evaluated with physiological tests after structural disorders and extracolonic causes have been excluded. Conservative treatment options should be tried unstintingly. It should be pointed out that especially new drugs such as prucalopride and linaclotide seem to be a big step forward in treating patients with chronic constipation. If surgery is indicated, for many years subtotal colectomy with IRA was the treatment of choice, although segmental resections were also a good option for isolated megasigmoid, sigmoidocele or recurrent sigmoid volvulus. Nowadays, less invasive procedures like sacral nerve modulation (SNM) should be tried first. If unsuccessful, colectomy can still be considered. In general, patients with a gastrointestinal dysmotility syndrome (GID) should not be offered any surgical options because of their anticipated poor results. Moreover, patients with psychiatric disorders should be actively discouraged from resection, as they tend to have a poorer prognosis. Patients must be counseled that pain and/or bloating will likely persist even if surgery normalizes bowel frequency. Patients with associated problems may be better served by having a stoma without resection as both a therapeutic maneuver and a diagnostic trial. Colectomy is not an option for the treatment of pain and/or abdominal bloating. In most cases outlet obstruction can be treated successfully with a conservative approach. However, nowadays there are also a variety of surgical options on the market. Each technique has its special place in the armamentarium of a colorectal surgeon but its exact role is not defined yet.The aim of this article is to give a brief overview, how to diagnose and treat chronic constipation from the standpoint of a colorectal surgeon.Surgical treatment of chronic constipation is not routine and is performed only in exceptional cases. But one thing first: a "too long gut" (dolichocolon) per se is never an indication for surgery. The aim of this manuscript is to give a brief overview about possible mechanisms of constipation, diagnostic methods and tools and the various conservative and operative treatment options. Moreover, please always keep in mind that constipation may not only be a symptom, but even a distinct disease!

• MeSH
• algoritmy MeSH
• anamnéza MeSH
• chirurgie trávicího traktu MeSH
• chronická nemoc MeSH
• diagnostické techniky gastrointestinální MeSH
• elektrostimulační terapie MeSH
• klyzma MeSH
• lidé MeSH
• plexus lumbosacralis MeSH
• projímadla terapeutické užití   MeSH
• zácpa etiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• projímadla MeSH

• MeSH
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH
• zácpa * diagnóza   etiologie   terapie   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• Bacteria izolace a purifikace   MeSH
• balneologie * MeSH
• cholecystektomie rehabilitace   MeSH
• chronická nemoc MeSH
• lidé MeSH
• minerální vody * MeSH
• tlusté střevo mikrobiologie   MeSH
• zácpa mikrobiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• minerální vody * MeSH

• MeSH
• autonomní nervový systém patofyziologie   MeSH
• balneologie * MeSH
• cholecystektomie rehabilitace   MeSH
• chronická nemoc MeSH
• dospělí MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• srdeční frekvence MeSH
• zácpa patofyziologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• lidé MeSH
• zácpa * diagnóza   etiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• balneologie * MeSH
• chronická nemoc MeSH
• lidé MeSH
• terapie cvičením metody   MeSH
• zácpa terapie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• dospělí MeSH
• elektrostimulační terapie * MeSH
• gastrointestinální motilita * MeSH
• lidé středního věku MeSH
• lidé MeSH
• tlusté střevo patofyziologie   MeSH
• zácpa patofyziologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• balneologie * MeSH
• cholecystektomie * MeSH
• chronická nemoc MeSH
• dipeptidylpeptidasy a tripeptidylpeptidasy krev   MeSH
• dospělí MeSH
• endopeptidasy krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pití MeSH
• senioři MeSH
• zácpa enzymologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• dipeptidylpeptidasy a tripeptidylpeptidasy MeSH
• endopeptidasy MeSH