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Do Children Just Grow Out of Irritable Bowel Syndrome?
Eleonora Giannetti1, Marco Maglione1, Elisa Sciorio1
1Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Naples, Italy.
Insights
Most children with irritable bowel syndrome (IBS) experience symptom resolution within 24 months. This natural history study found spontaneous improvement is common, irrespective of treatment or IBS subtype.
Area of Science:
- Pediatric Gastroenterology
- Clinical Research
- Natural History Studies
Background:
- Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder in children.
- Limited data exist on the long-term natural history and symptom evolution of IBS in pediatric populations.
- Understanding symptom progression is crucial for effective management strategies.
Purpose of the Study:
- To investigate the natural history of Irritable Bowel Syndrome (IBS) in a cohort of children.
- To analyze the evolution of IBS symptoms over a 24-month follow-up period.
- To assess the impact of therapeutic strategies on symptom resolution.
Main Methods:
- An observational, single-center study prospectively enrolled newly diagnosed pediatric IBS patients.
- Patients completed symptom questionnaires and stool consistency scores at diagnosis and after 24 months.
- Therapeutic strategies employed were systematically recorded.
Main Results:
- Of 83 children followed for 24 months, 57.8% reported symptom resolution (P < .001).
- Symptom resolution occurred irrespective of sex or IBS subtype.
- While not statistically significant, resolution was more frequent in children receiving no medical treatment compared to probiotics (63.8% vs 41.6%).
Conclusions:
- Pediatric Irritable Bowel Syndrome (IBS) often demonstrates spontaneous symptom resolution over a 24-month period.
- Resolution is independent of patient sex, age, symptom impact, or IBS subtype.
- Reassurance and watchful waiting may be effective management approaches for many children with IBS.
Objective:
Few data exist on natural history of irritable bowel syndrome (IBS) in children; therefore we investigated symptoms evolution over time in a cohort of children with IBS.
Study Design:
In this observational, single-center study, we prospectively enrolled newly diagnosed children with IBS and reassessed them after 24 months. At both time points, patients completed a symptoms questionnaire, and a score of stool consistency was obtained. The therapeutic strategy adopted was also recorded.
Results:
Eighty-three children (age 11 years, range, 4-16.6 years; 53 males) completed the study. Forty-seven (56.6%) patients received no medical treatment, whereas polyethylene glycol, probiotics, and trimebutine were prescribed to 9 (10.8%), 24 (28.9%), and 3 (3.6%) subjects, respectively. Twenty-four months after diagnosis, 48 children (57.8%) reported resolution of symptoms (P <.001), without differences between sexes (P = .35) or among IBS subtypes (P = .49). Of these, 30 (62.5%) had been only reassured and 18 (37.5%) had been prescribed medical treatment (P = .26). Despite not being statistically significant, symptoms resolution was more common in patients receiving no medical treatment than in those receiving probiotics (63.8% vs 41.6%, P = .08). Among patients with constipation-IBS, no difference was found in symptoms resolution between patients receiving polyethylene glycol and those receiving no medical treatment (67% and 40%, respectively, P = 1).
Conclusions:
Children with IBS are likely to show spontaneous symptoms resolution over a 24-month follow-up, regardless of sex, age, impact of symptoms on daily activities, and IBS subtypes.
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