Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic or recurrent abdominal pain/discomfort, altered bowel function (urgency, altered stool consistency, altered stool frequency, incomplete evacuation), and bloating/distention. These symptoms are felt to stem from the function of the bowels. They are not explained by identifiable structural or biochemical abnormalities. The two most commonly used symptombased criteria for IBS are the Manning criteria (Manning, Thompson, Heating, & Morris, 1978) and the Rome criteria (Thompson et al., 2000; Thompson et al., 1999). These criteria were originally developed for adults, but have been successfully used with children and adolescents. The Manning criteria were established to differentiate IBS from organic disease in patients attending an outpatient gastroenterology clinic. They have been used for patient selection in epidemiological studies and clinical trials and have served their original purpose well. The Manning criteria include the following: (1) visible abdominal distention, (2) relief of pain with bowel movement, (3) more frequent bowel movements with the onset of pain, (4) loose stools at onset of pain, (5) passage of mucous per rectum, and (6) feeling of incomplete evacuation. The Rome criteria resulted from consensus conferences to define criteria for a broad range of functional gastrointestinal disorders. The most recent version, the Rome II criteria (Rasquin-Weber et al., 1999), have emerged as the gold standard and require that the primary IBS symptoms must be continuous or recurrent for at least 3 months. The abdominal pain or discomfort has two or three features: (1) it is relieved with defecation, (2) associated with a change in frequency of stool, and/or (3) associated with a change in form of stool. No structural or metabolic abnormalities explain the symptoms. According to Rome II criteria, symptoms that cumulatively support the diagnosis of IBS include: abnormal stool frequency (> 3 BMs/day or < 3 BMs/week); abnormal stool form (lumpy/hard or loose/watery stool); abnormal stool passage (straining, urgency, or feeling of incomplete evaluation); passage of mucous; and bloating or feeling of abdominal distention. When appropriate, the Rome II criteria classify IBS as either “diarrhea-predominant” or “constipation-predominant” on the basis of the predominant bowel habit. For some individuals, diarrhea and constipation alternate.
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(2006). Irritable Bowel Syndrome. In: Pediatric Gastrointestinal Disorders. Springer, Boston, MA. https://doi.org/10.1007/0-387-25612-1_7
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