Self-management and treatment adherence in pediatric irritable bowel syndrome (IBS): A longitudinal study

Despite the increasing prevalence of pediatric irritable bowel syndrome (IBS), multifaceted treatment, and stomach pain being one of the most common reasons youth see the doctor, there is a dearth of literature concerning self-management in this population.

This pilot study addresses this by providing a characterization of these variables and associated factors via a microlongitudinal and longitudinal design.

Daily diary data from 50 youth (10-18 years old) diagnosed with IBS across three 7-day time points were analyzed via multi-level modeling. This study took place during the COVID-19 pandemic.

Most youth reported pain being a five out of ten and subjective well-being between five and eight. Oral medication/supplements were the most commonly reported treatment prescribed. However, the highest adherence was among those prescribed physical therapy. Youth were most likely to report their adherence strategy being/including caregiver reminders, and use of distraction as a coping skill to deal with their IBS pain. There was a significant inverted relationship between youth who reported caregivers reminded them to do treatment and/or they used a phone app with their report of well-being (β = -1.56, β = -2.29). Youth who reported greater confidence in their ability to problem-solve symptoms had significantly higher rates of physical activity (β = 0.06).

Self-management is important for youth experiencing chronic pain/IBS. Given the integrated treatment approach, common age of diagnosis, and intermittent symptom activity, identifying barriers and facilitators is critical to help tailor treatment and improve health outcomes. Future studies with larger samples should focus on further identification of modifiable variables to inform targeted interventions.