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Subtypes of irritable bowel syndrome in children and adolescents
Mariella M Self1, Danita I Czyzewski1, Bruno P Chumpitazi2
1Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas; Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas.
Insights
In children, irritable bowel syndrome (IBS) is most commonly IBS with constipation or unsubtyped. Unlike adults, IBS with diarrhea and mixed IBS are less frequent in pediatric patients. Subtypes were not distinguishable by demographics or pain.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
- Irritable Bowel Syndrome (IBS) Classification
Background:
- Accurate subtype classification is crucial for targeted pharmacologic treatments and symptom management in irritable bowel syndrome (IBS).
- Limited research exists on pediatric IBS subtypes, with previous studies facing methodological challenges.
- This study addresses the need for reliable classification of IBS subtypes in children and adolescents.
Purpose of the Study:
- To investigate the distribution of irritable bowel syndrome (IBS) subtypes in pediatric patients.
- To compare IBS subtypes based on demographic and pain characteristics.
- To provide a clearer understanding of pediatric IBS prevalence and presentation.
Main Methods:
- A prospective study involving 129 children and adolescents (ages 7-18) meeting Pediatric Rome III IBS criteria.
- Participants completed daily pain and stool diaries for two weeks.
- IBS subtypes were assigned using adult Rome III criteria based on stool diary data; demographic and pain data were analyzed for comparison.
Main Results:
- Irritable bowel syndrome with constipation (IBS-C) was the most prevalent subtype (58.1%), followed by unsubtyped IBS (34.1%).
- Irritable bowel syndrome with diarrhea (IBS-D) and mixed IBS were less common, accounting for 5.4% and 2.3% of subjects, respectively.
- No significant differences were found in sex, age, ethnicity, or pain characteristics among the different IBS subtypes.
Conclusions:
- In contrast to adult populations, IBS-C and unsubtyped IBS are the predominant subtypes in children.
- Pediatric IBS-D and mixed IBS subtypes are significantly less common than in adults.
- Demographic factors and pain characteristics do not reliably differentiate between IBS subtypes in children.
Background & Aims:
Pharmacologic treatments for irritable bowel syndrome (IBS) and medical management of symptoms are increasingly based on IBS subtype, so it is important to accurately differentiate patients. Few studies have classified subtypes of pediatric IBS, and conclusions have been challenged by methodologic limitations. We performed a prospective study to investigate the distribution of IBS subtypes among children and adolescents based on stool diary information, and compared subtypes according to demographic and pain characteristics.
Methods:
We studied 129 subjects, ages 7 to 18 years (mean age, 11.4 ± 2.8 y; 60.5% female; 69.0% white) who met Pediatric Rome III IBS criteria and were part of larger studies of children with functional gastrointestinal disorders, recruited from primary and tertiary care centers. Children completed daily pain and stool diaries for 2 weeks. Participants were assigned IBS subtypes based on their reported stool information per adult Rome III criteria. IBS subtypes were compared for demographic variables and pain characteristics.
Results:
IBS with constipation was the most common subtype of the disorder (58.1% of subjects), whereas mixed IBS was the least common (2.3% of subjects); 34.1% of subjects were unsubtyped IBS and 5.4% had IBS with diarrhea. The groups of different IBS subtypes did not differ significantly by sex, age, ethnicity, or pain characteristics.
Conclusions:
In contrast to adults, in children, IBS with constipation and unsubtyped IBS are the most common subtypes, whereas IBS with diarrhea and mixed IBS are less common. Demographic and pain characteristics cannot distinguish subtypes.
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