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[Irritable bowel syndrome in children]
Insights
Irritable bowel syndrome (IBS) is a common functional disorder in children. This study reviews epidemiological data, pathogenic hypotheses, and clinical presentations, emphasizing diagnosis and management strategies like dietary changes over medication.
Area of Science:
- Gastroenterology
- Pediatrics
- Functional Disorders
Context:
- Irritable bowel syndrome (IBS) is the most prevalent chronic functional gastrointestinal disorder affecting both children and adults.
- This study examines IBS in 332 children, comparing findings with existing literature.
Purpose:
- To evaluate epidemiological aspects, pathogenic hypotheses, and clinical presentations of IBS in children.
- To outline diagnostic and management strategies for pediatric IBS.
Summary:
- Epidemiological data, including frequency, sex, and age, along with family histories, were analyzed.
- Pathogenic hypotheses, particularly alterations in gastrointestinal motility influenced by psychological factors, prostaglandins, and bile acids, were considered.
- Clinical manifestations vary with age, ranging from infantile colic and toddler's diarrhea to recurrent abdominal pain in older children, often alternating with constipation.
Impact:
- Provides a comprehensive overview of pediatric IBS, aiding clinicians in diagnosis and management.
- Highlights the importance of parental reassurance and dietary adjustments over pharmacological interventions for long-term symptom control.
Abstract:
The irritable bowel syndrome (IBS) is the most common chronic functional gastroenterological disorder both in adults and in children. In this study we evaluate the different aspects of this syndrome, comparing our observations on 332 children with other studies. Epidemiological data (frequency, sex, age) are examined so as the family histories of gastroenterological disorders. We take in account several pathogenic hypotheses, especially with reference to the alterations of gastrointestinal motility, which could be caused by several factors (psychological, prostaglandins, bile acids, etc.). The clinical picture is very variable, variations depending on the age of children and on the time of onset of IBS. The colic of neonate, caused by retention of air, is the main symptom in the first months of life, followed by chronic diarrhoea, also defined as toddler's diarrhoea, sometime alternating with constipation. In later childhood, recurrent abdominal pain represents a common complaint, in association with diarrhoea or constipation. The principal steps for a proper diagnosis so as the main differential diagnosis are defined. We explain the most important features of management (reassuring parents, free diet), excluding prescription of drugs, that produce only a transitory and symptomatic relief, so as elimination diets, that cause only a failure to thrive without any improvement of symptoms.