Study of children with irritable bowel syndrome and treatment

Abstract

Irritable bowel syndrome (IBS) in the pediatric population represents a common yet underrecognized functional gastrointestinal disorder that significantly impairs quality of life and imposes substantial burdens on healthcare systems. This prospective interventional study aimed to characterize the clinical profile of children diagnosed with IBS according to Rome IV criteria and to evaluate the efficacy of a multimodal treatment approach combining dietary modification, behavioral therapy, and pharmacological intervention over a twelve‑week period. A total of one hundred twenty children aged eight to seventeen years were enrolled from a tertiary pediatric gastroenterology clinic. Baseline assessments included symptom severity scores using the Pediatric IBS Symptom Severity Scale, stool pattern classification according to the Bristol Stool Form Scale, and evaluation of anxiety and depression using validated pediatric tools. The treatment protocol consisted of low‑FODMAP dietary guidance, age‑appropriate cognitive behavioral therapy delivered in six sessions, and symptom‑targeted pharmacotherapy including peppermint oil, fiber supplementation, or low‑dose amitriptyline as indicated. Follow‑up assessments at four, eight, and twelve weeks demonstrated a significant reduction in abdominal pain frequency and intensity, improvement in stool consistency, and normalization of bowel habits in seventy‑eight percent of participants. Furthermore, comorbid anxiety scores decreased substantially in the subgroup with baseline psychological distress. Adverse events were mild and transient, limited to minor gastrointestinal discomfort during the initial dietary adjustment phase. These findings support the implementation of a personalized, multidisciplinary strategy for pediatric IBS, emphasizing that early recognition and combined non‑pharmacological and pharmacological measures yield superior outcomes compared to monotherapy. Limitations include the absence of a control group and the relatively short follow‑up period, suggesting the need for longer‑term randomized controlled trials. Nevertheless, this study provides pragmatic evidence for clinicians managing childhood IBS in everyday practice.