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Irritable Bowel Syndrome

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Pediatric Neurogastroenterology

Abstract

Irritable bowel syndrome (IBS) is a commonly encountered pediatric functional gastrointestinal disorder with varying clinical presentations. Multiple mechanisms likely contribute to its development and may include visceral hypersensitivity, altered gastrointestinal microbiota, mucosal immune activation, psychological disorders and cerebral activation, and altered gastrointestinal motility. The recently refined pediatric Rome (IV) criteria are more inclusive than adult criteria with respect to duration of symptoms and aid in diagnosis while avoiding exhaustive, low-yield medical testing. Although a myriad of therapeutic options are available for the treatment of IBS including medications, dietary manipulations, and behavioral and physical therapies, convincing evidence-based pediatric data to support any particular treatment modality are sparse. An effective management strategy is often multifaceted and should be individually tailored and symptom directed. Previous studies have demonstrated a particularly high placebo rate for the treatment of IBS, suggesting that with a strong physician–patient–family relationship, patients will improve regardless of the treatment approach. Future research in IBS will continue to focus on the pathophysiology of this disorder and on the discovery of more targeted therapies. Lastly, pediatric trials investigating the safety and effectiveness of current and emerging therapies approved in adult IBS are warranted.

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Authors and Affiliations

  1. Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT, 06106, USA

    Jasmeet S. Mokha M.D., M.P.H. & Jeffrey S. Hyams M.D.

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  1. Jasmeet S. Mokha M.D., M.P.H.
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  2. Jeffrey S. Hyams M.D.
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Correspondence to Jeffrey S. Hyams M.D. .

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  1. Division of Pediatric Gastroenterology Hepatology and Nutrition, CHU Sainte-Justine, Montreal, Québec, Canada

    Christophe Faure

  2. Department of Paediatric Gastroenterology, UCL Institute of Child Health, London, United Kingdom

    Nikhil Thapar

  3. Division of Pediatric Gastroenterology Hepatology, and Nutrition, Nationwide Children’s Hospital, Columbus, Ohio, USA

    Carlo Di Lorenzo

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Mokha, J.S., Hyams, J.S. (2017). Irritable Bowel Syndrome. In: Faure, C., Thapar, N., Di Lorenzo, C. (eds) Pediatric Neurogastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-319-43268-7_37

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