Abdominal Symptom Phenotype Study in Children

Functional gastrointestinal (GI) disorders (FGIDs), in particular irritable bowel syndrome (IBS) in adults and children, are among the most common and costly health care problems in the US. IBS disproportionately affects adult women (10-15% in western nations) and adolescent girls. Yet, health care providers remain challenged to provide effective clinical management. The etiology of IBS is not well defined and likely multi-factorial.

A Need to Define Subgroups of IBS:

This study emerges from the claim that identification of patient subgroups will advance our understanding of IBS and ultimately help develop treatment approaches. Most studies have lumped together patients with IBS into 2 groups (constipation-, diarrhea-predominant) and tested whether they differ from healthy controls. We propose that a paradigm shift is in order. We should recognize that IBS likely has multiple causes and therefore, multiple expressions. We speculate that by understanding better defined patient subgroups and linking them to newer biomarkers or tests, ultimately will further the understanding of the origins and create effective treatments.

Inclusion criteria

IBS:

• Age 7-12 years
• Females
• Meet criteria for irritable bowel syndrome without evidence of organic disease
• Developmentally normal
• English speaking (as the psychological measures are either not available or validated in Spanish)
• No other chronic, significant (e.g., diabetes, migraines) medical conditions
• No menses

Controls:

• Age 7-12 years
• Females
• No abdominal pain
• No GI or chronic medical conditions (e.g., diabetes)
• Developmentally normal
• English speaking (as the psychological measures are not available or validated in Spanish)
• No menses

Exclusion criteria

• Non-english speaking
• Developmentally or cognitively impaired
• Males
• Menses
• No mother in the household for administration of the psychological measures
• Use of any anti-depressants
• History of migraines or chronic pain disorders
• On narcotics for at least 1 week prior to enrollment
• On any NSAIDs or pain reliever for at least 24 hours prior to enrollment
• Sought psychotherapy in past 6 months for abdominal pain