Recurrent abdominal pain in children revisited: irritable bowel syndrome and psychosomatic aspects. A prospective study

Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain or discomfort that has occurred at least 3 days per month in the 3 months prior to diagnosis. One of the subtypes of this disorder is IBS with constipation (IBS-C), where individuals experience hard or lumpy stools at least 25% of the time and loose or watery stools less than 25% of the time with defecation. This review addresses IBS-C, detailing the epidemiology, etiology, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, and prognosis. A figure shows the Bristol stool form scale. Tables list IBS subtypes, components of digital rectal examination, differential diagnoses for IBS and IBS-C, alarm features, and the American College of Gastroenterology Recommendations. This review contains 1 highly rendered figure, 6 tables, and 71 references.

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Irritable bowel syndrome

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0308 ◽

2020 ◽

pp. 2951-2959

Author(s):

Adam D. Farmer ◽

Qasim Aziz

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Recurrent Abdominal Pain ◽

Bowel Habit ◽

Western World ◽

Older Individuals ◽

Butyl Bromide ◽

Rome Iii ◽

Fermentable Carbohydrates ◽

Irritable Bowel

Symptoms suggestive of disturbed lower gastrointestinal function without adequate explanation are very common in adults in the Western world, up to 15% of whom experience such symptoms at any one time, although most do not seek medical advice. The currently used terms are best viewed as an attempt to provide some clinically useful, rather than pathophysiologically accurate, categorization of patients and their symptoms based on disordered gut–brain interactions. Irritable bowel syndrome is defined according to the Rome III criteria as recurrent abdominal pain or discomfort associated with a change in bowel habit for at least 6 months, with symptoms experienced on at least 3 days of at least 3 months. Many subtypes are recognized. Routine haematological and biochemical screening is usually performed on the assumption that it will be normal. Features that raise the suspicion of organic disease and indicate a need for further investigation include the onset of symptoms in middle-aged or older individuals, weight loss, or blood in the stool. Management remains empirical: no single pharmacological agent or group of agents has ever been found to be consistently effective. The principal task of the physician is to provide explanation and reassurance (sometimes supplemented by psychological treatments), but particular symptoms are often treated as follows: (1) constipation—defecation may be eased by supplementary dietary fibre and poorly absorbed fermentable carbohydrates which increase faecal bulk and soften the stool; osmotic laxatives and enemas are used for the severely constipated patient, as well as more novel agents; (2) diarrhoea—attention to diet is often helpful, as are simple antidiarrhoeal agents; and (3) abdominal pain—antispasmodics (e.g. hyoscine butyl bromide) are frequently used, as are antidepressants.

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Recurrent Abdominal Pain in Children: Forerunner to Adult Irritable Bowel Syndrome?

Journal for Specialists in Pediatric Nursing ◽

10.1111/j.1088-145x.2003.00081.x ◽

2003 ◽

Vol 8 (3) ◽

pp. 81-89 ◽

Cited By ~ 19

Author(s):

Monica Jarrett ◽

Margaret Heitkemper ◽

Danita I. Czyzewski ◽

Robert Shulman

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Recurrent Abdominal Pain ◽

Irritable Bowel

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Irritable bowel syndrome and biliary tract pathology. Clinical analysis

Medical Council ◽

10.21518/2079-701x-2020-15-28-38 ◽

2020 ◽

pp. 28-38

Author(s):

T. E. Polunina

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Gastrointestinal Tract ◽

Biliary Tract ◽

Emotional Health ◽

Biological Marker ◽

Recurrent Abdominal Pain ◽

Clinical Analysis ◽

Functional Disorders ◽

Irritable Bowel

Irritable bowel syndrome (IBS) – a recurrent functional disorder of the gastrointestinal tract (GIT), the main symptom of which is abdominal pain necessarily associated with a change in intestinal function. IBS is a functional intestinal disorder in which recurrent abdominal pain is associated with a defecation act and a change in the frequency or shape of the stool. The diagnosis of IBS remains exclusively clinical. The difficulty in studying IBS, especially from the perspective of its epidemiology, is that there is still no universal and specific biological marker. Very often patients complain about symptoms typical for several functional disorders, in particular, biliary tract pathology and IBS. The article discusses the multi-component causes and mechanisms of IBS formation, which are also present in other functional gastrointestinal tract diseases. Patients with IBS often have functional disorders of the biliary tract (FDBT) that are not associated with organic pathology. There are no reliable differences in the frequency and nature of FDBT in patients with IBS, depending on its current variant - with constipation or diarrhea prevalence. As a result, the treatment of patients with IBS remains a challenge, and the recurrence of the disease depends on the state of psycho-emotional health, the presence of overlap syndrome in most cases. The article presents the main international criteria for diagnostics of IBS. The main approaches to the treatment of IBS are considered. Good results in the treatment of IBS are observed when using drugs that affect the complex of pathophysiological mechanisms of the disease. This is confirmed in the article by a clinical case study. The prescription of the Sparex drug for pain relief in a patient with IBS and FDBT is justified by the fact that it not only eliminates pain, but also improves the rheological properties of bile, typical for overlap “IBS-FDBT” syndrome.

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Effectiveness and applicability of low FODMAP diet in the irritable bowel syndrome: Preliminary results of a prospective study

10.32512/jmr/2.2.2019/4.9 ◽

2019 ◽

pp. 4-9

Keyword(s):

Irritable Bowel Syndrome ◽

Prospective Study ◽

Life Quality ◽

Treatment Efficiency ◽

Therapeutic Modalities ◽

Frequency Survey ◽

Irritable Bowel ◽

Fodmap Diet ◽

A Prospective Study

Abstract: Introduction: Irritable bowel syndrome (IBS) is a very common entity that alters patient’s life quality worldwide. Several therapeutic modalities are available with variable results. Recently, the low-FODMAP diet effect on IBS symptoms has been proven. The aim of our study was to study the efficiency of this diet and to assess its applicability in a Tunisian IBS group of patients. Methods: A longitudinal, prospective study including 34 patients with IBS was conducted. Patients responded to a food frequency survey and had to follow a low FODMAP diet with a dietary guide education for 3 weeks. After the diet, a telephone questionnaire was conducted to evaluate adherence and treatment efficiency. Results: Mean of the population age was 56.5 (21 – 83 years) with a sex ratio of almost 1⁄4. The initial food survey showed a large consumption of white bread and fruits. Tolerance to rich in FODMAP foods was variable among patients. Up to 97% of patients adhered to the low FODMAP diet. A decrease in abdominal pain in 88% of cases and in bloating in 64.7% of cases (p = 0.007) were noted after the diet. Conclusion: In our patients, the low FODMAP diet showed satisfactory results with good adherence, and improvement of IBS symptoms. However, it is important to note the difficulty of a long-term diet in a population with a variable alimentary habit. Key words: low FODMAP diet; irritable bowel syndrome, applicability, Tunisia

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PWE-131 Fodmap intake and the risk of irritable bowel syndrome in the community: a prospective study

10.1136/gutjnl-2018-bsgabstracts.425 ◽

2018 ◽

Author(s):

Mark Fox ◽

Cindy Long ◽

Yanyong Deng ◽

Hua Chu ◽

Yanqun Cong ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Prospective Study ◽

Irritable Bowel ◽

A Prospective Study

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Fructose and irritable bowel syndrome

Nutrition Research Reviews ◽

10.1017/s0954422420000025 ◽

2020 ◽

Vol 33 (2) ◽

pp. 235-243 ◽

Cited By ~ 1

Author(s):

Chloé Melchior ◽

Véronique Douard ◽

Moïse Coëffier ◽

Guillaume Gourcerol

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Breath Test ◽

Recurrent Abdominal Pain ◽

Fructose Malabsorption ◽

Chronic Disorder ◽

Gi Symptoms ◽

Irritable Bowel ◽

Osmotic Load

AbstractIrritable bowel syndrome (IBS) is a chronic disorder characterised by recurrent abdominal pain or discomfort and transit disturbances with heterogeneous pathophysiological mechanisms. The link between food and gastrointestinal (GI) symptoms is often reported by patients with IBS and the role of fructose has recently been highlighted. Fructose malabsorption can easily be assessed by hydrogen and/or methane breath test in response to 25 g fructose; and its prevalence is about 22 % in patients with IBS. The mechanism of fructose-related symptoms is incompletely understood. Osmotic load, fermentation and visceral hypersensitivity are likely to participate in GI symptoms in the IBS population and may be triggered or worsened by fructose. A low-fructose diet could be integrated in the overall treatment strategy, but its role and implication in the improvement of IBS symptoms should be evaluated. In the present review, we discuss fructose malabsorption in adult patients with IBS and the interest of a low-fructose diet in order to underline the important role of fructose in IBS.

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