Overview of Gastrointestinal Disorders in Neonates and Infants

Several gastrointestinal disorders can affect both neonates and infants, including

• Gastroesophageal reflux

• Hypertrophic pyloric stenosis

• Intussusception

• Meconium ileus

• Meconium plug syndrome

• Necrotizing enterocolitis

• Neonatal cholestasis

Neonates are also susceptible to other conditions that may become surgical emergencies such as inguinal hernia, gastric perforation, ileal perforation, and mesenteric arterial occlusion.

Infectious gastroenteritis is the most common pediatric gastrointestinal disorder. About 3 to 5 billion episodes occur worldwide each year, most commonly in medically underserved countries and predominately among children < 5 years of age. In 2016, diarrhea was the eighth leading cause of death, causing > 1.6 million. More than 27% of these deaths occurred among children < 5 years of age (1).

In the United States, more than 350 million cases of infectious gastroenteritis occur annually, leading to 100 to 300 deaths.

Approximately 2% of children in developed countries will require hospitalization at some time because of acute gastroenteritis and dehydration. In the United States, acute gastroenteritis accounts for an estimated 200,000 hospitalizations and 1.5 million outpatient visits at a cost in excess of 2 billion dollars. The incidence of rotavirus gastroenteritis, which was the most common viral cause, has decreased by 58 to 90% because of routine administration of the rotavirus vaccines. Norovirus is now the leading cause of acute gastroenteritis in children in the United States (2).

(See also Dehydration and Fluid Therapy in Children.)