Natural history of irritable bowel syndrome

Abstract

Background: Chronic diarrhea and functional abdominal pain (FAP) in childhood could be an early manifestation of adult irritable bowel syndrome (IBS). The aim of this study was to investigate the presence of chronic functional digestive symptoms in childhood, interviewing adult patients diagnosed with IBS, in an attempt to establish a relationship between them. Methods: By means of a questionnaire, the history of colic, chronic diarrhea, functional abdominal pain, constipation and migraine in childhood, was analyzed in patients diagnosed with IBS according to the current Rome III criteria, and in control patients without known chronic digestive disorders. Key words children, functional abdominal pain, irritable bowel syndrome.According to the diagnostic criteria defined by the recent Rome III Committee recommendations, irritable bowel syndrome (IBS) is a functional bowel disorder, in which there is a change in bowel habit or abdominal pain associated with defecation, with symptom onset at least 6 months prior to diagnosis. 1 IBS is the most common gastrointestinal diagnosis in adults experienced by 10-15% of the general population, with a predominance in women. 2-4The pathogenesis of adult IBS remains uncertain. Studies of twins generally support a genetic component in IBS, but social environment has an equal or greater contribution. The concordance for IBS between monozygotic twins was significantly greater than that between dizygotic twins, but the concordance between mothers and their respective children was greater than that between monozygotic twins.5 A large number of mothers of children with functional gastrointestinal disorders (FGID) have the same FGID as their children. 6 In addition, epidemiological studies have implicated psychosocial factors, such as life and psychological stresses; and various early childhood adverse life events also may carry an increased risk of IBS as an adult. 6-8Abdominal pain-related FGID, including recurrent functional abdominal pain (FAP) and IBS, are also observed in childhood, and the updated Roma III criteria for children aged 4-18 years have recently been published. 9 In clinical practice, the proportion of patients diagnosed with IBS is still very low in the pediatric age group, but recurrent FAP is often diagnosed. Many children and adolescents with FAP, however, will also meet criteria for IBS or other FGID. 10FAP is the most common recurrent pain in childhood, and approximately 10% of children experience FAP at any one time. 2The long-term outcome of this condition has not been determined, 11 although these children are more likely than their peers (without this symptom) to have lifelong psychiatric disorders as well as other painful somatic symptoms such as migraine headache. [12][13][14] Population-based studies have demonstrated that these children with FAP will report abdominal pain or symptoms of IBS 5-30 years later, 10,[15][16][17][18][19][20][21][22][23][24] in approximately one-third to one-half of affected children; a significantly higher proportio...

The Relationship between Infant Colic and Migraine as well as Tension-Type Headache: A Meta-Analysis

“…All of them were published in English language. Two studies included adult patients [21, 22], and 5 trials enrolled pediatric population [10–12, 20, 23]. Only one study did not indicate age of the included studies [11].…”

“…Only one study did not indicate age of the included studies [11]. The diagnosis of infant colic was made based on medical history provided by parents in 4 trials [10, 11, 20, 23], two studies confirmed infant colic through follow-up visiting and diagnosis by physicians [22, 24], and one study got the record from examinee questionnaire [21]. All the studies compared the occurrence of colic in migraine and control groups, and 2 trials of them also recorded that in TTH patients [10, 11].…”

The relationship between migraine and infant colic: A systematic review and meta-analysis

“…Thirty-six articles were identified in the PubMed searches. Three studies met inclusion criteria for the primary analysis (11,18,19) and an additional two met inclusion criteria for the secondary analysis (28,29).…”

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

“…Attempts at prevention of IBS is a challenge and a future opportunity to reduce the disease burden and minimize the wastage of large sums of public funds. It has been shown that a significant proportion of adults with IBS had childhood chronic abdominal pain and possibly IBS[ 251 ]. Therefore, the attempt to prevent FAPDs including IBS in childhood possibly have a compound effect to minimize economic burden of adults with IBS as well.…”