Elsevier

The Journal of Pediatrics

Volume 183, April 2017, Pages 122-126.e1
The Journal of Pediatrics

Original Articles
Do Children Just Grow Out of Irritable Bowel Syndrome?

https://doi.org/10.1016/j.jpeds.2016.12.036Get rights and content

Objective

Few data exist on natural history of irritable bowel syndrome (IBS) in children; therefore we investigated symptoms evolution over time in a cohort of children with IBS.

Study design

In this observational, single-center study, we prospectively enrolled newly diagnosed children with IBS and reassessed them after 24 months. At both time points, patients completed a symptoms questionnaire, and a score of stool consistency was obtained. The therapeutic strategy adopted was also recorded.

Results

Eighty-three children (age 11 years, range, 4-16.6 years; 53 males) completed the study. Forty-seven (56.6%) patients received no medical treatment, whereas polyethylene glycol, probiotics, and trimebutine were prescribed to 9 (10.8%), 24 (28.9%), and 3 (3.6%) subjects, respectively. Twenty-four months after diagnosis, 48 children (57.8%) reported resolution of symptoms (P <.001), without differences between sexes (P = .35) or among IBS subtypes (P = .49). Of these, 30 (62.5%) had been only reassured and 18 (37.5%) had been prescribed medical treatment (P = .26).

Despite not being statistically significant, symptoms resolution was more common in patients receiving no medical treatment than in those receiving probiotics (63.8% vs 41.6%, P = .08).

Among patients with constipation-IBS, no difference was found in symptoms resolution between patients receiving polyethylene glycol and those receiving no medical treatment (67% and 40%, respectively, P = 1).

Conclusions

Children with IBS are likely to show spontaneous symptoms resolution over a 24-month follow-up, regardless of sex, age, impact of symptoms on daily activities, and IBS subtypes.

Section snippets

Methods

Patients eligible for the study were all the children aged 5-17 years who were referred to the Department of Translational Medical Sciences, Section of Pediatrics of the “Federico II” University for RAP between March 2012 and January 2014. For all eligible children, a full medical history was collected, and patients underwent clinical evaluation, laboratory tests (full blood cell count, inflammatory markers, antitransglutaminase and antiendomysial antibodies, fecal calprotectin), and a

Results

Of the 330 eligible patients referred to our department for RAP between March 2012 and January 2014, 98 children received an IBS diagnosis. Of these, 83 patients completed the 24 month-follow-up study and were included in the data analysis (Figure 1; available at www.jpeds.com). Patient characteristics both at diagnosis and after 24 months are summarized in the Table.

At diagnosis, C-IBS was the most prevalent subtype, affecting 34 out of 83 children (41%). D-IBS and A-IBS were reported in 26

Discussion

In this longitudinal study, we aimed to investigate the evolution of IBS symptoms in a cohort of pediatric patients followed-up over 24 months. Our main finding was that approximately one-half of the enrolled subjects reported spontaneous resolution of symptoms over time, with no influence of sex, age, impact of symptoms on daily activities, or IBS-subtypes. Interestingly, despite larger interventional studies being needed, our results also seem to suggest that traditionally prescribed

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  • The authors declare no conflicts of interest.

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