The Clinical Features And The Experience Of Diagnosis And Treatment Of 80 Children With Irritable Bowel Syndrome

Objective:To investigate the clinical features of children with Irritable bowel syndrome(IBS),in order to achieve the early diagnosis and treatment and avoid unnecessary diagnostic approaches.Methods:A total of 80 hospitalized IBS patients in the Department of Gastroenterology of Children's Hospital of Chongqing Medical University from January 2012 to August 2018 were enrolled.We analyzed the clinical data of 80 cases and a literature review on diagnosis and treatment of childhood Irritable bowel syndrome was also conducted.Results:A total of 80 cases include 53 boys and 27 girls.The mean age at diagnosis was 9.70±2.88 years,and the median duration of disease was 10 months.(2)Abdominal pain was found in all cases(100%),followed by diarrhea in 60 cases(75.00%),constipation in 31cases(38.75%),abdominal distension in 21 cases(26.25%),vomiting in 19cases(23.75%),weight loss in 11 cases(13.75%),loss of appetite in 9 cases(11.25%),Other symptoms included headache in 3 cases(3.75%).About a third(29/80,36.25%)of the children had suspected triggers beforeonset,mostly diet factor(17 cases,21.25%).(3)80 cases with IBS include46 cases(57.50%)with IBS-D,17 cases(21.25%)with IBS-C,13cases(16.25%)with IBS-M and 4 cases(5.00%)with IBS-U.The number of boys with IBS-C and IBS-D was higher in boys than that of girls.IBS-M was on the contrary.IBS-U was equal between them.There are no significant differences in age,duration of disease and treatment effectiveness.Abdominal distension among four clinical types was statistically different(P<0.05),IBS-M has the highest incidence,followed by were IBS-C,IBS-D,IBS-U.The incidence of other symptoms such as vomiting,weight loss and loss of appetite were no significant differences in four types.(4)Treatment was aimed at patient education,psychological intervention,dietary management and symptomatic therapy(smectite,prebiotics or lactulose etc.).After the first 6 months visit of 74 cases,34cases(45.95%)were sustained relieved,25 cases(33.78%)were alleviated,the overall effective rate was 79.73%.15 cases(20.27%)were ineffective.Conclusion:IBS is a common functional gastrointestinal disorder in children.The data of this cases showed that there were more boys than girls,and the ages of 7-12 years were more than those of 4-7 years and 12-18 years.Some of the patients had suspected triggers before onset,mostly was diet factor.Patients with IBS often shows abdominal pain,abdominal distension,accompanied by altered bowel habits.IBS-D is most common among four types.Treatment mainly aimed at patienteducation,psychological intervention,dietary management and symptomatic therapy.The overall therapeutic effective rate was 79.73%.There are still some patients with poor curative effect.