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Irritable Bowel Syndrome

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Pediatric Neurogastroenterology

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Irritable bowel syndrome (IBS) is a commonly encountered functional gastrointestinal disorder seen in general pediatric as well as subspecialty practice. Given widely varying clinical presentations, multiple mechanisms likely contribute to the development of IBS. Current hypotheses regarding the pathophysiology of IBS involve visceral hypersensitivity, altered gastrointestinal microbiota, mucosal immune activation, psychiatric disorders and cerebral activation, and altered gastrointestinal motility. Prior to the advent of clinical criteria that culminated in the Rome III guidelines, IBS was considered a diagnosis of exclusion obliging extensive, often times low-yield medical testing in many patients. With clinical guidelines in place, the diagnosis of IBS can be usually made in a timely and efficient manner. There are myriad therapeutic options for the treatment of IBS involving medications, dietary manipulations, and behavioral and physical therapies. However, there is little strong evidence to support any one particular approach. An effective strategy is often multifaceted and should be individually tailored and symptom directed. Previous studies have demonstrated a particularly high placebo rate for the treatment of IBS, suggesting that with a strong physician-patient-family relationship, patients will improve regardless of the treatment approach. Future research in IBS will be focused on the pathophysiology of this disorder in the hopes of discovering more targeted therapies.

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Authors and Affiliations

  1. Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT, 06106, USA

    Bella Zeisler M.D. & Jeffrey S. Hyams M.D.

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  1. Bella Zeisler M.D.
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  2. Jeffrey S. Hyams M.D.
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Correspondence to Jeffrey S. Hyams M.D. .

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Editors and Affiliations

  1. Sainte-Justine Hospital, Department of Pediatrics, Division of Pediatric Gastroenterology, Université de Montréal, Montreal, H3T 1C5, Québec, Canada

    Christophe Faure

  2. Nationwide Children's Hospital, Division of Pediatric Gastroenterology, The Ohio State University, Columbus, 43205, Ohio, USA

    Carlo Di Lorenzo

  3. Gastroenterology and Neural Development, University College London, Institute of Child Health, Great Ormond Street Hospital for Children, London, WC1N 1EH, United Kingdom

    Nikhil Thapar

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Zeisler, B., Hyams, J.S. (2013). Irritable Bowel Syndrome. In: Faure, C., Di Lorenzo, C., Thapar, N. (eds) Pediatric Neurogastroenterology. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-709-9_34

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