Elsevier

The Journal of Pediatrics

Volume 164, Issue 5, May 2014, Pages 1099-1103.e1
The Journal of Pediatrics

Original Article
Subtypes of Irritable Bowel Syndrome in Children: Prevalence at Diagnosis and at Follow-Up

https://doi.org/10.1016/j.jpeds.2013.12.043Get rights and content

Objectives

To assess the prevalence of irritable bowel syndrome (IBS) subtypes in childhood at diagnosis and their changes over 1 year.

Study design

This is an observational, prospective, multicenter study. Consecutive pediatric patients with IBS, according to Rome III criteria, were enrolled over a 1-year period. Parents recorded weekly stool frequency and consistency and gastrointestinal and extraintestinal symptoms in a diary. Stool consistency was scored according to the Bristol Stool Form Scale. Children were evaluated after 2, 3, 6, and 12 months.

Results

We enrolled 100 children with IBS (median age 9.9 years, range 4.2-16.7 years, 52 girls and 48 boys). At time of enrollment, constipation-IBS was the prevalent subtype (45%), with a prevalence of girls at 62% (P < .005); diarrhea-IBS was reported in 26% of children, with a prevalence of boys at 69% (P < .005); and alternating-IBS was described in 29% of children, without a difference between sexes. During the follow-up, 10% of patients changed their IBS subtypes at 2 months, 9% at 3 months, 7% at 6 months, and 6.3% at 12 months. Twenty-four percent of patients changed IBS subtype between the time of enrollment and 12 months.

Conclusions

Constipation-IBS is the prevalent subtype in children, with a higher frequency in girls. In boys, diarrhea-IBS is the most common subtype. It is important to acquire knowledge about IBS subtypes to design clinical trials that may eventually shed new light on suptype-specific approaches to this condition.

Section snippets

Methods

Patients eligible for the study were children aged 5-17 years who were referred for abdominal pain and subsequently received a diagnosis of IBS at 1 of 5 different Italian pediatric clinics—University of Naples “Federico II”, University of Foggia, Hospital-University of Parma, University “Magna Graecia” of Catanzaro, and University of Insubria, Varese—between January 2010 and January 2012. IBS was diagnosed using the Rome III criteria for pediatric functional gastrointestinal disorders (FGIDs).1

Results

Of 113 patients eligible for the study, 11 (9.7%) declined participation. Two children (1.8%) were excluded from the study because they improved after the 2-week lactose-free diet trial. In all subjects, laboratory findings were unremarkable. No children changed from IBS to another FGID during the study period.

We enrolled 100 children with diagnosis of IBS (48 boys and 52 girls, median age 9.9 years, range 4.2-16.7 years). Median time between onset of symptoms and diagnosis was 6.2 months

Discussion

The major findings of our study were that: (1) C-IBS was the prevalent subtype, with a significantly higher frequency in girls, and D-IBS was more frequent in boys; (2) the prevalent subtype did not change during the 12-month follow-up period; (3) there was a variation in bowel pattern in 24% of children during the follow-up period; and (4) among the intestinal and extraintestinal symptoms considered, none was related to IBS subtypes.

In our study, distribution of IBS subtypes showed that C-IBS

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    The authors declare no conflicts of interest.

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