IBS Subtypes in Pediatrics

A recent study (Clin Gastroenterol Hepatol 2014; 12: 1468-73) examined irritable bowel syndrome (IBS) subtypes among 129 subjects ages 7 to 18 who met Pediatric Rome III IBS criteria.  These children were part of larger studies of functional gastrointestinal disorders and recruited from primary and tertiary care centers.  Participants completed pain and stool diaries.

Key finding:

  • IBS with constipation (IBS-C) was the most common subtype (58.1%); in the other categories IBS unsubtyped (IBS-U) was next at 34.1%, then IBS with diarrhea (IBS-D) at 5.4%, and least common was mixed IBS (IBS-M) at 2.3%

The authors note that in adults with IBS studies tend to yield a more even distribution among the subtypes IBS-C, IBS-D, and IBS-U along with smaller numbers in IBS-M.

Take-home message: IBS with constipation is common in pediatrics.  Among patients who have been labelled as having isolated constipation, many in fact have IBS-C and may have persistent gastrointestinal symptoms despite the use of laxatives.

Related blog post:

Mechanisms of irritable bowel syndrome | gutsandgrowth

2 thoughts on “IBS Subtypes in Pediatrics

  1. Please see my post below (since I quote you) and let me know if you have any thoughts–thanks

    Irritable Bowel Syndrome (IBS) in Children and Teens

    Irritable bowelsyndrome (IBS, also known as a spastic colon) is a frequent problem in adults,and a not infrequent one, in school children. The widely accepted criteriaestablished by a group of international physicians meeting together in Rome (andthus called the Rome criteria) helps to define the condition. Recurrent abdominal pain ordiscomfort at least 3 days/month in the last 3 months with two or more of thefollowing: . Improvementwith a bowel movement . Associated witha change in the frequency of bowel movements . Onsetassociated with a change in form (appearance) of the bowel movement Often, the pain ordiscomfort is more frequent and it can be I-think-I-am-going-to-die intense. Thecritical part is the bowel movements are different than they usuallyare–either more and usually loose (called IBS-D for diarrhea; IBS-C forconstipation, IBS-M (mixed, meaning the BM are different but they vary) orIBS-U for those that aren’t yet typed. The percentage ofadults who have the different types are about equal, except that there aren’tmany who have the mixed type, going back and forth from constipation todiarrhea. A recent study (Clin Gastroenterol Hepatol 2014; 12: 1468-73) evaluated 129 subjects between the ages 7 and 18 who met the Pediatric Rome IIIIBS criteria (That’s the newest version). The key finding was that · IBS with constipation(IBS-C) was the most common subtype (58.1%); · IBS -U (the untyped) wasnext at 34.1%, · then IBS with diarrhea(IBS-D) at 5.4%, · and least common wasmixed IBS (IBS-M) at 2.3% The Take-home message, as Dr. Jay Hochman points out in his blog,gutsandgrowth: Among patients who have been labelled as having constipation,many, in fact, have IBS-C and may have persistent gastrointestinal symptomsdespite the use of laxatives. The good news is thata High Fiber Diet <> often helps in both constipation, whenit occurs by itself. and in IBS-C. But in IBS-C, you may want to use ourSymptom Diary <>to sort out other factors that may be contributingto the problem (like stress or other dietary factors, or a lack of exercise);and if a High Fiber Diet doesn’t help, you may want to talk to your doctorabout the FODMAP diet <> that has been helpful for manypatients with IBS.

  2. Pingback: Clinically Useful Biomarkers for Irritable Bowel Syndrome? | gutsandgrowth

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