Irritable Bowel Syndrome in Children and Adolescents
There is no specific test for diagnosing IBS. Consequently, obtaining a detailed patient history and clinical symptoms remains extremely important for diagnosis. IBS is diagnosed by applying the Rome III criteria (Table 1) and ruling out red-flag symptoms that may be caused by other organic GI diseases. The Rome III criteria identify symptom clusters for various functional GI disorders, including IBS.
The Rome III criteria define IBS as recurrent abdominal pain or discomfort that is associated with alterations in defecation and changes in stool consistency. Accordingly, recurrent abdominal pain or discomfort for 3 or more days per month in the preceding 3 months that is associated with two or more of the following is diagnostic of IBS: improvement of symptoms upon defecation; onset associated with change in form and/or appearance of stool; abnormal stool frequency; straining during defecation; urgency or feeling of defecation; mucus in stool; and bloating. Red-flag symptoms that indicate a more serious abdominal disorder or GI disease other than IBS include anemia, weight loss, rectal bleeding, nocturnal or progressive abdominal pain, severe diarrhea or vomiting, delayed puberty, fever of unknown origin, and family history of inflammatory bowel disease.
Diagnosis
There is no specific test for diagnosing IBS. Consequently, obtaining a detailed patient history and clinical symptoms remains extremely important for diagnosis. IBS is diagnosed by applying the Rome III criteria (Table 1) and ruling out red-flag symptoms that may be caused by other organic GI diseases. The Rome III criteria identify symptom clusters for various functional GI disorders, including IBS.
The Rome III criteria define IBS as recurrent abdominal pain or discomfort that is associated with alterations in defecation and changes in stool consistency. Accordingly, recurrent abdominal pain or discomfort for 3 or more days per month in the preceding 3 months that is associated with two or more of the following is diagnostic of IBS: improvement of symptoms upon defecation; onset associated with change in form and/or appearance of stool; abnormal stool frequency; straining during defecation; urgency or feeling of defecation; mucus in stool; and bloating. Red-flag symptoms that indicate a more serious abdominal disorder or GI disease other than IBS include anemia, weight loss, rectal bleeding, nocturnal or progressive abdominal pain, severe diarrhea or vomiting, delayed puberty, fever of unknown origin, and family history of inflammatory bowel disease.
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