# Irritable bowel syndrome in children with chronic gastrointestinal symptoms in primary care

## TL;DR

This study examines how children with irritable bowel syndrome (IBS) differ in treatment and quality of life compared to other children with chronic gut issues in primary care.

## Contribution

The study identifies differences in prognosis and treatment between children with IBS and others, and highlights misalignment between general practitioner diagnoses and Rome criteria.

## Key findings

- Children with IBS were more likely to be referred to secondary care and use laxatives.
- Children with IBS had higher rates of chronic diarrhea and lower physical quality of life.
- Only 10% of general practitioners' IBS diagnoses matched the Rome criteria.

## Abstract

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder in children. However, in primary care, it is still unknown whether there are differences in the prognosis of children with IBS compared to other diagnostic subgroups. Therefore, our aim was to describe the course of symptoms and health-related quality of life (HRQoL) for children with chronic gastrointestinal symptoms who either do or do not fulfil the Rome criteria for IBS in primary care. Second, we compared the diagnosis of the general practitioner (GP) with the Rome criteria.

We conducted a prospective cohort study with 1-year follow-up, including children aged 4–18 years with chronic diarrhoea and/or chronic abdominal pain in primary care. During follow-up, the Rome III questionnaire, Child Health Questionnaire, and symptom questionnaires were completed.

A total of 60/104 children (57.7%) fulfilled the Rome criteria for IBS at baseline. Compared to children without IBS, children with IBS were more commonly referred to secondary care, used more laxatives, and more often developed chronic diarrhoea and low physical HRQoL during 1 year. The diagnosis “IBS” from the GP matched the Rome criteria for only 10% of children, as most were diagnosed with “Constipation.”

There seems to be a difference in the treatment and prognosis of symptoms and HRQoL between children with and without IBS in primary care. This suggests that it is relevant to differentiate between these groups. The evaluation and use of feasible criteria to define IBS in different healthcare settings remains subject for further studies.