Location: Children's Nutrition Research CenterTitle: Subtypes of irritable bowel syndrome in children and adolescents
|SELF, MARIELLA - Baylor College Of Medicine|
|CZYZEWSKI, DANITA - Baylor College Of Medicine|
|CHUMPITAZI, BRUNO - Texas Children'S Hospital|
|WEIDLER, ERICA - Children'S Nutrition Research Center (CNRC)|
|SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)|
Submitted to: Clinical Gastroenterology and Hepatology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/1/2014
Publication Date: 9/1/2014
Citation: Self, M.M., Czyzewski, D.I., Chumpitazi, B.P., Weidler, E.M., Shulman, R.J. 2014. Subtypes of irritable bowel syndrome in children and adolescents. Clinical Gastroenterology and Hepatology. 12:1468-1473.
Interpretive Summary: 15-20% of children and adults are affected by intestinal disorders such as irritable bowel syndrome (IBS). This condition is not the same in everyone. We performed a prospective study to investigate the distribution of IBS subtypes among children and adolescents based on stool diary information, and compared subtypes according to demographic and pain characteristics. As a result, a treatment that is effective in one person may not work in another. This study describes the different types of IBS that may be present in children and will help guide appropriate treatment. This information is important because some types of IBS can be improved by changing the composition of the diet whereas others are not responsive to changes in diet.
Technical Abstract: Pharmacologic treatments for irritable bowel syndrome (IBS) and medical management of symptoms are increasingly based on IBS subtype, so it is important to accurately differentiate patients. Few studies have classified subtypes of pediatric IBS, and conclusions have been challenged by methodologic limitations. We performed a prospective study to investigate the distribution of IBS subtypes among children and adolescents based on stool diary information, and compared subtypes according to demographic and pain characteristics. We studied 129 subjects, ages 7 to 18 years (mean age, 11.4 +/- 2.8 y; 60.5% female; 69.0% white) who met Pediatric Rome III IBS criteria and were part of larger studies of children with functional gastrointestinal disorders, recruited from primary and tertiary care centers. Children completed daily pain and stool diaries for 2 weeks. Participants were assigned IBS subtypes based on their reported stool information per adult Rome III criteria. IBS subtypes were compared for demographic variables and pain characteristics. IBS with constipation was the most common subtype of the disorder (58.1% of subjects), whereas mixed IBS was the least common (2.3% of subjects); 34.1% of subjects were unsubtyped IBS and 5.4% had IBS with diarrhea. The groups of different IBS subtypes did not differ significantly by sex, age, ethnicity, or pain characteristics. In contrast to adults, in children, IBS with constipation and unsubtyped IBS are the most common subtypes, whereas IBS with diarrhea and mixed IBS are less common. Demographic and pain characteristics cannot distinguish subtypes.