Irritable bowel syndrome in children: Current knowledge, challenges and opportunities

Abstract

Irritable bowel syndrome (IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS.

Ileocolonic Lymphonodular Hyperplasia in Children Related to Etiologies Ranging from Food Hypersensitivity to Familial Mediterranean Fever

“…A final diagnosis of FMF was made, according to the Tel Hashomer criteria [12], by a pediatric rheumatologist. The diagnosis of irritable bowel syndrome (IBS) was made by clinical parameters as defined previously [13]. Skin prick test and/or food-specific IgE were negative in patients with IBS.…”

Shaoyao‐Gancao Decoction Relieves Visceral Hyperalgesia in TNBS‐Induced Postinflammatory Irritable Bowel Syndrome via Inactivating Transient Receptor Potential Vanilloid Type 1 and Reducing Serotonin Synthesis

“…Visceral hypersensitivity is considered as the common clinical feature among all PI-IBS patients [ 5 ]. Increased sensitivity to distension of the colon and rectal ballooning are observed in ∼50% of PI-IBS patients.…”

Estudio de la Legalidad Brasileña de las Escuelas Públicas Municipales en Cuanto a la Promoción de la Alimentación Sana para el Control y Prevención de la Salud Oral en el Contexto de las Enfermedades Gastrointestinales Inflamatorias

“…En Brasil, la prevalencia de enfermedades crónicas, que produce manifestaciones orales y que pueden interferir en la conducta del profesional de Odontología y en el establecimiento del plan de tratamiento, viene aumentando. Estos cambios en el perfil se caracterizan como un problema de salud pública de-mostrando que las principales causas de las enfermedades están asociadas a la alimentación inadecuada (de Moraes et al, 2014;Andrade et al, 2015;Didari et al, 2015;Distrutti et al, 2016;Enck et al, 2017;Revoredo et al, 2017;Mazzawi & El-Salhy, 2017;Devanarayana & Rajindrajith, 2018).…”

“…Las enfermedades gastrointestinales inflamatorias son una expresión generalmente utilizada para definir un grupo de enfermedades inflamatorias intestinales que se dividen en la enfermedad de Crohn, la colitis ulcerosa y la enfermedad celíaca. Los países económicamente desarrollados, así como la mayoría de los países en desarrollo, están actualmente definiendo estrategias para el control de esas enfermedades, teniendo como una de las estrategias la promoción de la alimentación sana, que es un componente importante en la prevención de estos problemas y en la educación alimentaria y nutricional, siendo por lo tanto una estrategia fundamental de intervención en el marco mencionado (Didari et al;Revoredo et al;Mazzawi & El-Salhy;Devanarayana & Rajindrajith;Protásio et al, 2018).…”