Irritable Bowel Syndrome in Children

Irritable bowel syndrome in children (synonyms: colon dyskinesia, chronic spastic colitis, IBS) is a functional intestinal disorder in which abdominal pain or discomfort is associated with bowel movements, a change in the habitual rhythm of bowel functioning, 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 disturbances.
• K59.0. Constipation.
• K59.1. Functional diarrhea.
• K59.2. Neurogenic irritability of the intestine, not classified elsewhere.

Epidemiology of irritable bowel syndrome in children

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

In China, with a survey of 5,403 schoolchildren aged 6-18 years, the prevalence of irritable bowel syndrome was 13%; ratio of boys and girls 1: 1.8. The disease with equal frequency is recorded in children under 12 years (12%) and adolescents over 13 years (11%). Among the older children, the highest prevalence was recorded at the age of 15-16 (17%).

[1], [2], [3]

Causes of irritable bowel syndrome in children

Irritable bowel syndrome is the result of violation of biological, psychological and social adaptation of a person, the formation is based on a change in visceral sensitivity and motor activity of the intestine, persistent disruption of the cooperation of the nervous and immune systems of the body.

What causes irritable bowel syndrome?

[4], [5], [6], [7], [8], [9], [10]

Symptoms of Irritable Bowel Syndrome in Children

Roman criteria III (2006) emphasize specialists' attention to the main clinical symptoms of irritable bowel syndrome:

• the frequency of defecation is less than 3 times a week or more 3 times a day;
• rough and hard or soft and watery stools;
• straining during defecation;
• imperative urges for defecation (inability to delay bowel evacuation), sensation of incomplete bowel emptying;
• excretion of mucus during defecation;
• feeling of overflow, bloating or transfusion in the abdomen.

Symptoms of irritable bowel syndrome

Classification

Irritable bowel syndrome is a stable set of functional disorders lasting not less than 12 weeks for the last 12 months, accompanied by pain (discomfort) in the abdomen, which corresponds to the following characteristics:

• passes after defecation;
• accompanied by a change in the frequency and consistency of the stool;
• for 25% of the duration of the disease is combined with 2 (or more) persistent symptoms of bowel dysfunction (change in stool frequency, stool consistency, mucus secretion with feces, flatulence, defecation act - imperative urges, tenesmus, incomplete bowel emptying, defecation).

Types of irritable bowel syndrome

[11], [12], [13], [14], [15]

Diagnosis of irritable bowel syndrome in children

Irritable bowel syndrome is the diagnosis of an exception. For children, symptoms that exclude the diagnosis of irritable bowel syndrome are unmotivated weight loss, persisting symptoms at night (during sleep), persistent intense abdominal pain, progression of the condition, fever, rectal bleeding, painless diarrhea, steatori, lactose intolerance, fructose and gluten, changes in laboratory parameters (Roman criteria III, 2006).

Diagnosis of irritable bowel syndrome

[16], [17], [18], [19], [20]

Treatment of irritable bowel syndrome in children

The diet is selected individually depending on the leading clinical symptoms. Exclude spicy seasonings, foods rich in essential oils, raw vegetables, fruits, restrict milk. The set of products is adjusted taking into account the tolerability, the nature of motor disorders, the predominance of proteolytic (putrefactive) or saccharolytic (fermenting) microflora. Nutrition is fractional, 5-6 times a day.

Irritable bowel syndrome with a predominance of diarrhea is recommended mechanically and chemically sparing diets № 46 and 4в (depending on the clinical picture). Products containing little connective tissue are shown - veal, lean pork, rabbit meat, white turkey meat and chicken, low-fat fish.

How is irritable bowel syndrome treated?