title: Altered fecal microflora and increased fecal calprotectin in infants with colic.
abstract: OBJECTIVE
  We explored whether gut inflammation, colonic fermentation, and/or an altered colonic flora could provide a pathophysiological mechanism for colic.
  
  
  METHODS
  The study population consisted of 36 term infants ranging in age from 14 to 81 days. We measured fecal calprotectin (a marker of neutrophil infiltration) by ELISA; stool microorganisms by denaturing gradient gel electrophoresis, cloning, and sequencing; and breath hydrogen levels using gas chromatography.
  
  
  RESULTS
  During 24 hours, infants with colic (n = 19) cried and fussed for a mean of 314 +/- 36 (SEM) minutes, compared with control infants (n = 17, 103 +/- 17 minutes). Fecal calprotectin levels were 2-fold higher in infants with colic than in control infants (413 +/- 71 vs 197 +/- 46 microg/g, P = .042). Stools of infants with colic had fewer identifiable bands on denaturing gradient gel electrophoresis. Klebsiella species were detected in more colic patients than in control patients (8 vs 1, P = .02), whereas Enterobacter/Pantoea species were detected only in the control patients. These differences could not be attributed to differences in formula versus breast milk feeding, consumption of elemental formula, or exposure to antibiotics.
  
  
  CONCLUSIONS
  Infants with colic, a condition previously believed to be nonorganic in nature, have evidence of intestinal neutrophilic infiltration and a less diverse fecal microflora.
authors.affiliation: Department of Pediatrics, University of Texas Health Sciences Center at Houston-School of Medicine, Houston, TX 77030, USA. J.Marc.Rhoads@uth.tmc.edu
authors.forename: J Marc
authors.initials: JM
authors.lastname: Rhoads
authors.forename: Nicole Y
authors.initials: NY
authors.lastname: Fatheree
authors.forename: Johana
authors.initials: J
authors.lastname: Norori
authors.forename: Yuying
authors.initials: Y
authors.lastname: Liu
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Lucke
authors.forename: Jon E
authors.initials: JE
authors.lastname: Tyson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ferris
mesh_terms: D001944:Breath Tests; D016022:Case-Control Studies; D003085:Colic / Q000378:metabolism* / Q000382:microbiology* / Q000473:pathology; D003448:Crying; D005243:Feces / Q000737:chemistry* / Q000382:microbiology*; D005260:Female; D005759:Gastroenteritis / Q000150:complications / Q000378:metabolism / Q000382:microbiology; D006801:Humans; D006859:Hydrogen / Q000378:metabolism; D007223:Infant; D007231:Infant, Newborn; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis / Q000378:metabolism*; D008297:Male; D020556:Neutrophil Infiltration / Q000502:physiology
chemical_list: D039841:Leukocyte L1 Antigen Complex; D006859:Hydrogen