Irritable Bowel Syndrome in Adolescents

Irritable Bowel Syndrome (IBS) is known to affect 10 to 20% of the adult population. In the absence of "red flags" (symptoms suggestive of organic disease) and abnormal findings during physical examination, typical IBS symptoms, together with a limited number of relevant investigative tests, have high diagnostic value(1). A recent study by Thompson et al. confirms that although most people do not consult for IBS, those that do constitute 1/3 of patients presenting with gastrointestinal symptoms to a family physician (2,3). In fact, IBS represents the vast majority of functional gastrointestinal disorders seen by general practitioners. In the same study, it was demonstrated that among IBS patients, a major predictor of referral to a specialist is denial of the influence of stress on their gastrointestinal symptoms(2). Other predictors include the severity of diarrhea, duration of symptoms, and number of tests performed. It has also been shown that more psychological and psychiatric disorders are found in IBS patients consulting a gastroenterologist than those seen by a general practitioner(4). When compared to the vast knowledge pertaining to adults with IBS, very little is known about IBS in the pediatric population. Since Apley and Nash's description in 1958 of the "Recurrent Abdominal Pain" (RAP) syndrome in children, research indicates that 1020% of school-aged youngsters experience abdominal pain frequently and severely enough to affect their daily activities(5). More recently, clinical and laboratory observations have helped distinguish organic diseases from functional disorders.