IBS in Children.doc

Irritable Bowel Syndrome in Children: Education, Reassurance, and Management Wed, 06/26/13 - 11:09 Authors:? SCOTT NIGHTINGALE, BMed(Hons), MClinEpid, FRACP, and NICHOLAS J. TALLEY, MD, PhD, FRACP Dr Nightingale is a pediatric gastroenterologist at John Hunter Children’s Hospital in New Lambton, New South Wales, Australia, and a conjoint lecturer in pediatrics and child health at the University of Newcastle in New South Wales. Dr Talley is a gastroenterologist at John Hunter Hospital in New Lambton and pro-vice chancellor and professor on the Faculty of Health at the University of Newcastle. Citation:? Consultant For Pediatricians. 2013;12(6):257-259 ? ABSTRACT:?Irritable bowel syndrome (IBS), a common condition in children and adolescents, is characterized by chronic abdominal pain with associated changes in bowel habit. A positive diagnosis can be made clinically, and extensive or invasive investigation often is not required. The pathophysiology of pediatric IBS, as with that of adults, is not fully understood. Genetic and psychosocial risk factors have been identified, and accumulating evidence suggests roles for the gut microbiota, increased intestinal permeability, immune activation, and central nervous system dysfunction, which may be primary or secondary to gut derangements. The mainstays of management are education, reassurance, and a biopsychosocial approach. Specific therapies such as dietary changes, probiotics, peppermint oil, and other pharmacotherapy also may have a role in management. ? Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (FGID) encountered in pediatric practice. It is characterized by abdominal pain or discomfort, an abnormal bowel habit linked to pain, and often bloating.1?By definition, there must be no evidence of anatomic, metabolic, or neoplastic processes that explain the symptoms.2?Inflammation once was considered to be an exclusion, but accumulating evidence points to the presence of subtle inflam