Italian guidelines for the management of irritable bowel syndrome in children and adolescents : Joint Consensus from the Italian Societies of: Gastroenterology, Hepatology and Pediatric Nutrition (SIGENP), Pediatrics (SIP), Gastroenterology and Endoscopy (SIGE) and Neurogastroenterology and Motility (SINGEM).
Children
Chronic abdominal pain
Constipation
Diarrhea
Functional gastrointestinal disorders
Irritable bowel syndrome
Journal
Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759
Informations de publication
Date de publication:
14 Mar 2024
14 Mar 2024
Historique:
received:
22
01
2024
accepted:
11
02
2024
medline:
18
3
2024
pubmed:
15
3
2024
entrez:
15
3
2024
Statut:
epublish
Résumé
The irritable bowel syndrome (IBS) is a functional gastrointestinal disorder (FGID), whose prevalence has widely increased in pediatric population during the past two decades. The exact pathophysiological mechanism underlying IBS is still uncertain, thus resulting in challenging diagnosis and management. Experts from 4 Italian Societies participated in a Delphi consensus, searching medical literature and voting process on 22 statements on both diagnosis and management of IBS in children. Recommendations and levels of evidence were evaluated according to the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. Consensus was reached for all statements. These guidelines suggest a positive diagnostic strategy within a symptom-based approach, comprehensive of psychological comorbidities assessment, alarm signs and symptoms' exclusion, testing for celiac disease and, under specific circumstances, fecal calprotectin and C-reactive protein. Consensus also suggests to rule out constipation in case of therapeutic failure. Conversely, routine stool testing for enteric pathogens, testing for food allergy/intolerance or small intestinal bacterial overgrowth are not recommended. Colonoscopy is recommended only in patients with alarm features. Regarding treatment, the consensus strongly suggests a dietary approach, psychologically directed therapies and, in specific conditions, gut-brain neuromodulators, under specialist supervision. Conditional recommendation was provided for both probiotics and specific fibers supplementation. Polyethylene glycol achieved consensus recommendation for specific subtypes of IBS. Secretagogues and 5-HT4 agonists are not recommended in children with IBS-C. Certain complementary alternative therapies, antispasmodics and, in specific IBS subtypes, loperamide and rifaximin could be considered.
Identifiants
pubmed: 38486305
doi: 10.1186/s13052-024-01607-y
pii: 10.1186/s13052-024-01607-y
pmc: PMC10938778
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
51Informations de copyright
© 2024. The Author(s).
Références
Gastroenterology. 2007 Nov;133(5):1430-6
pubmed: 17919634
J Dig Dis. 2018 Sep;19(9):522-528
pubmed: 30094945
J Clin Epidemiol. 2011 Apr;64(4):401-6
pubmed: 21208779
JAMA Pediatr. 2022 Apr 01;176(4):349-356
pubmed: 35099543
Nutrients. 2023 Jun 10;15(12):
pubmed: 37375612
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):617-640
pubmed: 33716293
Microb Pathog. 2022 Jan;162:105215
pubmed: 34592369
JAMA Pediatr. 2017 May 1;171(5):470-477
pubmed: 28346581
J Pediatr Gastroenterol Nutr. 2009 Nov;49(5):580-3
pubmed: 19633576
Gastroenterology. 1988 Feb;94(2):409-18
pubmed: 3335315
World J Clin Pediatr. 2022 Jul 9;11(4):330-340
pubmed: 36052114
J Pediatr Gastroenterol Nutr. 2017 Jan;64(1):133-153
pubmed: 27622898
J Pediatr. 1996 Aug;129(2):220-6
pubmed: 8765619
Aliment Pharmacol Ther. 2011 Jun;33(12):1302-10
pubmed: 21507030
J Pediatr Gastroenterol Nutr. 2022 Sep 1;75(3):356-368
pubmed: 35706093
Neurogastroenterol Motil. 2015 May;27(5):684-92
pubmed: 25809794
BMC Psychiatry. 2012 Jul 27;12:90
pubmed: 22839681
Am J Gastroenterol. 2013 Sep;108(9):1508-15
pubmed: 23835436
J Pediatr Gastroenterol Nutr. 2011 Feb;52(2):162-5
pubmed: 21150653
J Pediatr. 2008 May;152(5):685-9
pubmed: 18410774
Ann Parasitol. 2021;67(3):505-513
pubmed: 34953126
Expert Opin Drug Metab Toxicol. 2012 Oct;8(10):1327-35
pubmed: 22985444
Nat Rev Gastroenterol Hepatol. 2013 Aug;10(8):473-86
pubmed: 23797870
Nutrients. 2021 Jun 16;13(6):
pubmed: 34208479
Pediatrics. 2010 Dec;126(6):e1445-52
pubmed: 21078735
J Pediatr. 2015 Nov;167(5):1103-8.e2
pubmed: 26329806
Aliment Pharmacol Ther. 2007 Jan 15;25(2):177-84
pubmed: 17229242
J Pediatr Gastroenterol Nutr. 2011 Apr;52(4):382-6
pubmed: 21240023
BMC Gastroenterol. 2022 Dec 29;22(1):547
pubmed: 36581912
J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):898-902
pubmed: 26960173
Child Care Health Dev. 2010 Nov;36(6):781-6
pubmed: 20645991
J Pediatr Gastroenterol Nutr. 2013 Aug;57(2):141-8
pubmed: 23698023
J Pediatr. 2013 Apr;162(4):783-7
pubmed: 23069193
JAMA Pediatr. 2022 Jun 1;176(6):560-568
pubmed: 35404394
Clin Gastroenterol Hepatol. 2018 Jun;16(6):870-876
pubmed: 29129667
J Pediatr Gastroenterol Nutr. 2015 Apr;60(4):498-502
pubmed: 25406525
J Pediatr Gastroenterol Nutr. 2010 Jul;51(1):24-30
pubmed: 20453678
Am J Gastroenterol. 2005 Sep;100(9):2071-8
pubmed: 16128954
J Pediatr Gastroenterol Nutr. 2014 Aug;59(2):244-53
pubmed: 25025601
PLoS Med. 2007 Mar 27;4(3):e98
pubmed: 17388664
Am J Gastroenterol. 2005 Sep;100(9):2079-82
pubmed: 16128955
Cochrane Database Syst Rev. 2021 Feb 9;2:CD008013
pubmed: 33560523
Neurogastroenterol Motil. 2014 Feb;26(2):196-204
pubmed: 24304324
Arch Dis Child. 2020 Oct;105(10):938-944
pubmed: 32152039
World J Pediatr. 2022 May;18(5):320-332
pubmed: 35106700
Pediatrics. 2005 Sep;116(3):e393-6
pubmed: 16140684
Am J Gastroenterol. 2017 Jan;112(1):152-162
pubmed: 27845338
Neurogastroenterol Motil. 2019 Feb;31(2):e13509
pubmed: 30549152
Aliment Pharmacol Ther. 2015 Aug;42(4):418-27
pubmed: 26104013
J Pediatr. 2018 Apr;195:134-139
pubmed: 29398057
J Epidemiol Community Health (1978). 1978 Jun;32(2):79-85
pubmed: 681590
Clin Pediatr (Phila). 2011 May;50(5):396-401
pubmed: 21242200
J Pediatr. 2008 Nov;153(5):646-50
pubmed: 18538790
J Pediatr Gastroenterol Nutr. 2017 Oct;65(4):361-363
pubmed: 28777126
J Pediatr. 2020 Apr;219:76-82.e3
pubmed: 31987658
J Health Organ Manag. 2003;17(1):37-52
pubmed: 12800279
Clin Gastroenterol Hepatol. 2018 Feb;16(2):219-225.e1
pubmed: 28970147
J Korean Med Sci. 2012 Nov;27(11):1398-404
pubmed: 23166424
J Pediatr. 2017 Mar;182:155-163.e7
pubmed: 28081889
Dig Liver Dis. 2023 May;55(5):608-613
pubmed: 36682923
Eur J Pediatr. 2007 Dec;166(12):1245-52
pubmed: 17345097
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):546-551
pubmed: 33306584
J Pediatr Gastroenterol Nutr. 2014 Oct;59(4):493-9
pubmed: 24897168
Am J Gastroenterol. 2012 Apr;107(4):627-31
pubmed: 22310221
Pediatrics. 2005 Dec;116(6):e767-76
pubmed: 16322133
Public Health Nutr. 2001 Dec;4(6A):1433-8
pubmed: 11918496
J Clin Gastroenterol. 2016 Mar;50(3):227-32
pubmed: 25930973
Clin Chem. 2003 Jun;49(6 Pt 1):861-7
pubmed: 12765980
BMC Pediatr. 2012 May 16;12:54
pubmed: 22591492
Health Technol Assess. 2013 Nov;17(55):xv-xix, 1-211
pubmed: 24286461
J Pediatr Gastroenterol Nutr. 2016 Jan;62(1):47-9
pubmed: 26252922
J Pediatr Gastroenterol Nutr. 2014 Feb;58(2):258-74
pubmed: 24345831
Gastroenterology. 2016 Feb 15;:
pubmed: 27144631
Turk J Gastroenterol. 2016 Sep;27(5):439-443
pubmed: 27782892
J Pediatr Gastroenterol Nutr. 2011 Sep;53(3):260-4
pubmed: 21865971
Turkiye Parazitol Derg. 2008;32(1):4-7
pubmed: 18351542
J Pediatr. 2016 Oct;177:39-43.e3
pubmed: 27156185
BMC Med. 2021 Sep 16;19(1):214
pubmed: 34526042
Int J Nurs Stud. 2009 Jan;46(1):76-84
pubmed: 18722617
Gastroenterology. 2014 Jul;147(1):69-77
pubmed: 24657623
Dig Liver Dis. 2005 Oct;37(10):773-8
pubmed: 16023904
Handb Exp Pharmacol. 2017;239:147-176
pubmed: 28236087
J Pediatr. 2009 Sep;155(3):416-20
pubmed: 19535093
Expert Opin Drug Metab Toxicol. 2018 Jul;14(7):753-760
pubmed: 29897844
Am J Gastroenterol. 2010 Dec;105(12):2697-701
pubmed: 20808296
World J Gastroenterol. 2013 Jan 14;19(2):235-40
pubmed: 23345946
J Pediatr Gastroenterol Nutr. 2015 Jun;60(6):792-8
pubmed: 26000888
Clin Gastroenterol Hepatol. 2022 Mar;20(3):602-610.e5
pubmed: 33838349
Aliment Pharmacol Ther. 2006 Jan 1;23(1):191-6
pubmed: 16393297
J Gastroenterol Hepatol. 2022 Apr;37(4):685-691
pubmed: 34935191
Eur J Gastroenterol Hepatol. 2013 Oct;25(10):1223-9
pubmed: 24002016
Isr Med Assoc J. 2004 Nov;6(11):677-80
pubmed: 15562805
Arch Dis Child. 2014 Dec;99(12):1109-13
pubmed: 25053737
J Neurogastroenterol Motil. 2012 Jul;18(3):298-304
pubmed: 22837878
Gastroenterology. 2014 Dec;147(6):1285-95.e1
pubmed: 25239590
J Egypt Soc Parasitol. 2015 Aug;45(2):389-96
pubmed: 26485858
J Pediatr Gastroenterol Nutr. 2001 Sep;33(3):250-2
pubmed: 11593117
World J Gastroenterol. 2014 May 28;20(20):6031-43
pubmed: 24876726
Neurogastroenterol Motil. 2018 Oct;30(10):e13379
pubmed: 29856100
J Pediatr. 2001 Jan;138(1):125-8
pubmed: 11148527
J Abnorm Child Psychol. 2013 Jan;41(1):151-63
pubmed: 22773359
J Investig Med. 2018 Apr;66(4):755-761
pubmed: 29374025
Child Care Health Dev. 2010 Jul;36(4):516-23
pubmed: 20412144
Complement Ther Med. 2011 Jun;19(3):109-14
pubmed: 21641514
Am J Gastroenterol. 2018 Mar;113(3):421-430
pubmed: 29380821
Clin Gastroenterol Hepatol. 2017 May;15(5):712-719.e4
pubmed: 27080737
Gut. 2012 Sep;61(9):1284-90
pubmed: 22234979
J Neurogastroenterol Motil. 2013 Jan;19(1):90-3
pubmed: 23350053
J Pediatr Gastroenterol Nutr. 2015 Nov;61(5):558-60
pubmed: 26111293
Pediatr Allergy Immunol. 2002 Apr;13(2):113-8
pubmed: 12000483
Ann Fam Med. 2010 Mar-Apr;8(2):134-40
pubmed: 20212300
J Pak Med Assoc. 2008 Apr;58(4):171-4
pubmed: 18655423
Benef Microbes. 2018 Jun 15;9(4):563-572
pubmed: 29695183
PLoS One. 2021 Feb 11;16(2):e0246091
pubmed: 33571226
World J Gastroenterol. 2014 May 28;20(20):6013-23
pubmed: 24876724
Am J Gastroenterol. 2018 Jun;113(Suppl 2):1-18
pubmed: 29950604
Lab Invest. 1989 Jun;60(6):847-51
pubmed: 2733385
Paediatr Drugs. 2023 Jan;25(1):115-126
pubmed: 36380186
Electron Physician. 2015 Sep 16;7(5):1255-60
pubmed: 26435825
Clin Gastroenterol Hepatol. 2007 Oct;5(10):1175-83
pubmed: 17686660
Eur J Pediatr. 2023 Jul;182(7):2943-2956
pubmed: 37071174
J Pediatr. 2014 May;164(5):1099-1103.e1
pubmed: 24485818
J Pediatr Gastroenterol Nutr. 2016 Nov;63(5):481-487
pubmed: 27050045
Pharmacoepidemiol Drug Saf. 2002 Jan-Feb;11(1):31-5
pubmed: 11998549
Neurogastroenterol Motil. 2017 Mar;29(3):
pubmed: 27679978
Pediatrics. 2013 Sep;132(3):475-82
pubmed: 23940244
BMC Gastroenterol. 2020 Apr 6;20(1):86
pubmed: 32252644
J Clin Psychiatry. 2008 Mar;69(3):425-32
pubmed: 18294025
Am J Gastroenterol. 2004 Aug;99(8):1579-84
pubmed: 15307880
PLoS One. 2021 Aug 6;16(8):e0255160
pubmed: 34358238
Rev Gastroenterol Mex. 2015 Jul-Sep;80(3):186-91
pubmed: 26297182
J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):925-929
pubmed: 27906800
J Pediatr Gastroenterol Nutr. 2018 May;66(5):732-737
pubmed: 29045351
J Pediatr. 2009 Mar;154(3):322-6
pubmed: 19038403
J Pediatr Gastroenterol Nutr. 2013 Apr;56(4):443-8
pubmed: 23201712
Dig Liver Dis. 2023 Feb;55(2):187-207
pubmed: 36517261
Acta Paediatr. 2011 Nov;100(11):1461-7
pubmed: 21557765
Neurogastroenterol Motil. 2006 Feb;18(2):91-103
pubmed: 16420287
J Pediatr. 2015 Apr;166(4):903-7.e1
pubmed: 25661403
J Pediatr Gastroenterol Nutr. 2010 Oct;51(4):481-7
pubmed: 20562723
Clin Pediatr (Phila). 2019 Jan;58(1):79-87
pubmed: 30306797
Przegl Epidemiol. 1998;52(3):309-15
pubmed: 9919925
Aliment Pharmacol Ther. 2021 Jul;54(2):109-128
pubmed: 34115894
North Clin Istanb. 2020 Aug 14;7(5):433-437
pubmed: 33163877
Gastroenterology. 2016 Feb 15;:
pubmed: 27144632
J Pediatr. 2013 Sep;163(3):767-70
pubmed: 23522860
J Trop Pediatr. 2014 Oct;60(5):386-92
pubmed: 25059210
Paediatr Drugs. 2021 May;23(3):307-314
pubmed: 33876403
J Pediatr Gastroenterol Nutr. 2017 Jan;64(1):26-30
pubmed: 27035379
J Am Acad Child Adolesc Psychiatry. 2006 Jun;45(6):737-744
pubmed: 16721324
BMC Gastroenterol. 2012 Oct 15;12:142
pubmed: 23067390
Endoscopy. 2017 Jan;49(1):83-91
pubmed: 27617420
Neurogastroenterol Motil. 2023 Mar;35(3):e14365
pubmed: 35340083
J Pediatr Gastroenterol Nutr. 2002 Sep;35(3):329-33
pubmed: 12352522
Turkiye Parazitol Derg. 2016 Mar;40(1):32-6
pubmed: 27222333
Mymensingh Med J. 2014 Jan;23(1):105-13
pubmed: 24584382
J Pediatr Gastroenterol Nutr. 2007 Apr;44(4):524-6
pubmed: 17414158
J Clin Gastroenterol. 2017 Jan;51(1):e5-e10
pubmed: 27306945
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):542-545
pubmed: 33230076
J Pediatr. 2005 Aug;147(2):197-201
pubmed: 16126049
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):538-541
pubmed: 33394887
Dig Dis Sci. 2007 Feb;52(2):329-35
pubmed: 17211701
J Pediatr. 2008 Jun;152(6):812-6, 816.e1
pubmed: 18492522
Appetite. 2011 Aug;57(1):272-7
pubmed: 21624407
J Pediatr Gastroenterol Nutr. 2005 Jul;41(1):1-7
pubmed: 15990620
Pediatrics. 2004 Apr;113(4):817-24
pubmed: 15060233
Clin Gastroenterol Hepatol. 2014 Sep;12(9):1468-73
pubmed: 24486406
Aliment Pharmacol Ther. 2010 Aug;32(4):582-90
pubmed: 20528827
Gastroenterology. 2016 Feb 19;:
pubmed: 27144617
Rev Gastroenterol Mex. 2017 Jan - Mar;82(1):13-18
pubmed: 27546626
Pediatr Neurol. 2014 Jan;50(1):49-56
pubmed: 24269169
Eur Rev Med Pharmacol Sci. 2013 May;17(10):1314-20
pubmed: 23740443
JAMA Pediatr. 2014 Jun;168(6):555-60
pubmed: 24756157
Int Arch Allergy Immunol. 2020;181(1):31-42
pubmed: 31694023
J Pain. 2013 Sep;14(9):921-30
pubmed: 23685184
Aliment Pharmacol Ther. 2014 Dec;40(11-12):1349-58
pubmed: 25270840
Saudi J Gastroenterol. 2009 Oct-Dec;15(4):239-43
pubmed: 19794269
J Pediatr Gastroenterol Nutr. 2023 Jan 1;76(1):14-19
pubmed: 36136861
J Pediatr Gastroenterol Nutr. 2013 Aug;57(2):197-203
pubmed: 23535761
J Pediatr Gastroenterol Nutr. 2023 Feb 1;76(2):232-247
pubmed: 36219218
Gastroenterology. 2009 Oct;137(4):1261-9
pubmed: 19596010
World J Clin Cases. 2018 Dec 6;6(15):944-951
pubmed: 30568950
Gastroenterol Hepatol (N Y). 2019 Aug;15(8):414-422
pubmed: 31592242
J Clin Med. 2017 Oct 26;6(11):
pubmed: 29072609
Arch Dis Child. 2000 Feb;82(2):131-5
pubmed: 10648366
Lancet Gastroenterol Hepatol. 2019 Nov;4(11):831-844
pubmed: 31474542
J Trop Pediatr. 2011 Feb;57(1):34-9
pubmed: 20525779
J Pediatr Gastroenterol Nutr. 2018 Sep;67(3):414-430
pubmed: 30130311
Acta Paediatr. 2016 May;105(5):e232-6
pubmed: 26933798