Irritable bowel syndrome in children

Irritable bowel syndrome in children (synonyms: colonic dyskinesia, chronic spastic colitis, IBS) is a functional intestinal disorder in which abdominal pain or discomfort is associated with defecation, a change in the usual rhythm of bowel function, or a defecation disorder.

ICD-10 codes

• K58. Irritable bowel syndrome.
• K58.0. Irritable bowel syndrome with diarrhea.
• K58.9. Irritable bowel syndrome without diarrhea.
• K59. Other functional intestinal disorders.
• K59.0. Constipation.
• K59.1. Functional diarrhea.
• K59.2. Neurogenic irritability of intestine, not elsewhere classified.

Epidemiology of irritable bowel syndrome in children

15-20% of the world's population suffers from irritable bowel syndrome, and 2/3 of people with symptoms of irritable bowel syndrome do not seek medical help. The ratio of women to men varies from 1:1 to 2:1. The average age of patients is 24-41 years, 13.5% of patients are aged 15-34 years. The prevalence of irritable bowel syndrome among children and adolescents in the United States and Europe is about 10-14%.

In China, when examining 5403 schoolchildren aged 6-18 years, the prevalence of irritable bowel syndrome was 13%; the ratio of boys to girls was 1:1.8. The disease is recorded with equal frequency in children under 12 years (12%) and adolescents over 13 years (11%). Among older children, the highest prevalence was recorded at the age of 15-16 years (17%).

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Causes of Irritable Bowel Syndrome in Children

Irritable bowel syndrome is the result of a violation of biological, psychological and social adaptation of a person, the basis of formation lies in changes in visceral sensitivity and intestinal motor activity, persistent disturbances in the cooperation of the nervous and immune systems of the body.

What causes irritable bowel syndrome?

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Symptoms of irritable bowel syndrome in children

Rome III criteria (2006) focus the attention of specialists on the main clinical symptoms of irritable bowel syndrome:

• frequency of bowel movements less than 3 times a week or more than 3 times a day;
• rough and hard or soft and watery stools;
• straining during bowel movements;
• imperative urge to defecate (inability to delay bowel movement), sensation of incomplete bowel movement;
• mucus secretion during defecation;
• a feeling of fullness, bloating, or distension in the abdomen.

Symptoms of irritable bowel syndrome

Classification

Irritable bowel syndrome is a persistent set of functional disorders lasting at least 12 weeks over the past 12 months, accompanied by pain (discomfort) in the abdomen that meets the following characteristics:

• passes after defecation;
• accompanied by a change in the frequency and consistency of stool;
• for 25% of the duration of the disease, it is combined with 2 (or more) persistent symptoms of bowel dysfunction (changes in stool frequency, stool consistency, mucus discharge with stool, flatulence, bowel movement disorder - imperative urges, tenesmus, feeling of incomplete bowel emptying, additional efforts during bowel movements).

Types of irritable bowel syndrome

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Diagnosis of irritable bowel syndrome in children

Irritable bowel syndrome is a diagnosis of exclusion. For children, symptoms that exclude the diagnosis of irritable bowel syndrome include unexplained weight loss, persistence of symptoms at night (during sleep), persistent severe abdominal pain, progression of the condition, fever, rectal bleeding, painless diarrhea, steatorrhea, lactose, fructose and gluten intolerance, changes in laboratory parameters (Rome Criteria III, 2006).

Diagnosis of irritable bowel syndrome

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Treatment of irritable bowel syndrome in children

The diet is selected individually depending on the leading clinical symptoms. Exclude hot spices, products rich in essential oils, raw vegetables, fruits, limit milk. The set of products is adjusted taking into account tolerance, the nature of motor disorders, the predominance of proteolytic (putrefactive) or saccharolytic (fermentative) microflora. Meals are fractional, 5-6 times a day.

In case of irritable bowel syndrome with predominant diarrhea, mechanically and chemically gentle diets No. 46 and 4b are recommended (depending on the clinical picture). Products containing little connective tissue are indicated - veal, lean pork, rabbit meat, white meat of turkey and chicken, lean fish.

How is irritable bowel syndrome treated?