Management of irritable bowel syndrome in children

OverviewIBS is a clinical condition involving frequent (≥4 days per month) and chronic (>2 months) abdominal pain and stooling disturbance.Bloating is a common and highly annoying accompanying symptom.Diagnosis is established by applying symptom criteria elucidated through a series of medical expert pools (the "ROME" process I, II, III, and IV).Diagnostic criteria are quite similar for children and adults 1 .With regard to bowel movement disturbances, a constipation predominant pattern is more common in children than a diarrhea predominant pattern or a mixed, alternating constipation/diarrhea pattern 2-4 .Pattern shifts over time are rather common 3 .IBS disease mechanisms so far identified are multiple, varied and not always fully understood.Pathophysiological features of IBS that are supported by solid scientific evidence include visceral hypersensitivity, gastrointestinal dysmotility, gut inflammation, dietary triggers, intestinal dysbiosis and disturbances of the gut-brain axis.Thus, IBS may be considered pathogenetically a heterogeneous entity, as recently reviewed 5 .Familial aggregation is often noticeable but it is unclear whether genetic or environmental influences, including heightened awareness of abdominal sensations, are responsible.