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Clinical characteristics and nutritional profiles of children with different irritable bowel syndrome subtypes: a
Ziyu Liu1, Qiancheng Xu1, Xinyun Wu1
1Department of Pediatric Endoscopy Center and Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China.
Insights
Diarrhea-predominant irritable bowel syndrome (IBS-D) is common in hospitalized children, especially boys. Nutritional status and obesity vary significantly across IBS subtypes and sexes, highlighting the need for personalized care.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Gut-Brain Interaction Disorders
Background:
- Irritable bowel syndrome (IBS) is a common gut-brain interaction disorder (DGBI) in children.
- Limited data exists on clinical heterogeneity and nutritional profiles across pediatric IBS subtypes.
Purpose of the Study:
- To characterize clinical features of pediatric IBS subtypes.
- To assess nutritional status variations across IBS subtypes and sexes in hospitalized children.
Main Methods:
- Retrospective analysis of 478 hospitalized children diagnosed with IBS.
- Collection of demographic, clinical, and nutritional data, including height-for-age Z-scores (HAZ) and body mass index-for-age Z-scores (BAZ).
Main Results:
- Diarrhea-predominant IBS (IBS-D) was the most common subtype (61.9%), particularly in boys.
- Significant differences in HAZ and BAZ were observed between IBS-D and constipation-predominant IBS (IBS-C) subtypes.
- Malnutrition (112 children) and obesity (74 children) were prevalent, associated with selective eating, decreased appetite, and psychiatric comorbidities. Boys with IBS-D showed higher BAZ and obesity rates than girls.
Conclusions:
- IBS-D is predominant in hospitalized children, especially boys, with notable variations in nutritional status across subtypes and sexes.
- Findings underscore the importance of evaluating nutritional status, psychological health, and lifestyle factors.
- Individualized, multidisciplinary management strategies are recommended for pediatric IBS.
Background:
Irritable bowel syndrome (IBS) is a common disorder of gut‑brain interaction (DGBI) in children, but data on its clinical heterogeneity and nutritional profiles across different IBS subtypes remain limited. This study aimed to characterize the clinical features of IBS subtypes and assess variations in nutritional status across subtypes and sexes in hospitalized children.
Methods:
Children hospitalized with an initial diagnosis of IBS at the Children's Hospital, Zhejiang University School of Medicine (January 2020 to October 2025) were enrolled. Demographic and clinical data regarding nutritional status were obtained.
Results:
Among 478 children with IBS (mean age, 12.29±2.19 years; 57.3% boys), diarrhea-predominant IBS (IBS-D) was the most common subtype (n=296, 61.9%), with a higher proportion of boys (66.6%). Sleep disturbances and symptom aggravation by cold/irritant foods varied by subtypes, with constipation-predominant IBS (IBS-C) being more likely to have sleep issues (P<0.008). Nutritional assessment showed higher height-for-age Z-scores (HAZs) and body mass index-for-age Z-scores (BAZs) in IBS-D than in IBS-C (P=0.003 and P=0.002, respectively), and hemoglobin levels also varied significantly across subtypes (F=18.13, P<0.001). Based on BAZ, 112 children were found with malnutrition, and 74 with obesity. Children with malnutrition more frequently exhibited selective eating behaviors (19.6% vs. 8.6% in normal-weight children) and decreased appetite (64.3%). Children with malnutrition and obesity had more psychiatric comorbidities (P=0.02). Boys with IBS-D had a higher BAZ (P=0.006) and obesity prevalence than girls (24.4% vs. 11.1% in girls, P=0.007).
Conclusions:
IBS-D predominated in hospitalized children, particularly in boys, and nutritional status differed across IBS subtypes and between sexes. These findings highlight the importance of comprehensive evaluation of nutritional status, psychological health, and lifestyle factors and support the need for individualized and multidisciplinary management strategies for children with IBS.
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