Irritable bowel syndrome( IBS) in children( infants, newborns, early adolescents) and in adolescents, treatment, symptoms, differential diagnosis

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A fairly large number of young children( according to statistical data, there is almost 15%), suffer from irritable bowel syndrome. In the youngest patients, diagnosing this pathology is usually difficult, since they can not yet describe their feelings in words. In this case, to identify IBS, young parents are advised to pay attention to the characteristic symptomatology, which is as follows:

  • Irritable bowel syndrome in young children is accompanied by a constant change of constipation and diarrhea;
  • A child with a pathology such as IBS becomes more moody, does not sleep well and often cries;
  • The seat on the pot lasts longer than usual.

If the baby has these symptoms and has been stable for at least six months, and normal digestion has been disturbed, then it is recommended that children undergo appropriate tests before the diagnosis of irritable bowel syndrome and appropriate treatment is made to rule out the presence of other diseases.

The question of why irritable bowel syndrome occurs in a newborn is of concern to many parents, because it is believed that newly born babies have a sterile digestive system. So where does the negative symptom take? In a child, the emergence of this pathology can mostly be aggravated heredity or malnutrition of the mother. In infants, this ailment, expressed in a complex of gastrointestinal symptoms, develops due to the emergence of psychoemotional phenomena, inflammation reactions and the nature of nutrition in the absence of any structural or biochemical disorders of the gastrointestinal tract.

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Symptoms of irritable bowel syndrome in infants depend on the nature of the course of the disease. In the case of predominance of the phenomena of diarrhea, liquid stool appears mainly in the mornings, and at night there is no. There are also imperative urges for defecation, occurring within a fairly short period of time up to 4-5 times. Usually, if a child has IBS of this type, the first portion of the bowel movement, as a rule, has a formal character. Only subsequent acts of defecation pass with the release of watery or mucilaginous feces. For the most part, these manifestations of irritable bowel syndrome in children are accompanied by spastic pain, which causes the baby to press the legs under her and cry.

In the event that the child has a variant of IBS with a predominance of constipation, acts of defecation appear irregularly, often less than 3 times a week and cause the baby to push hard. The stool of the infants in this case has the appearance of lumps or "ribbons".Constipation in children with irritable bowel syndrome alternates with diarrhea, and also have a permanent or periodic character.

It is noted in toddlers of the very early age and unclassified form of pathology, when there are no prevalent symptoms. For the diagnosis of irritable bowel syndrome, signs of the disease should be noted in children for at least 3 months. Studies in this disease are necessary differential, to exclude other diseases of the gastrointestinal tract, which have similar symptoms.

Treatment of irritable bowel syndrome in children

Therapy of infants with IBS should be strictly individual, depending on the clinical course of the pathology. It requires a certain approach to each child, taking into account his personal characteristics. Regardless of the form of the ailment, a small patient is prescribed diet and phytotherapy. The use of medicines in the treatment of irritable bowel syndrome in newborn infants should be resorted only to the ineffectiveness of these therapies, based on the leading symptomatology.

An essential condition for effective treatment of pathology in infants is the creation of an adequate regimen, which includes correction of the diet of the nursing mother and compliance with hygiene requirements. Children with irritable bowel syndrome should be protected from any psychotraumatic situations. A favorable microclimate should be created in the family. Also, children with IBS should ensure the possibility of regular water procedures and walks. It must be remembered that a sick child needs an intensified drinking regime. Treatment of IBS in children who are on artificial feeding, provides for a change of mixture. Doctors infants with artificial constipation appoint those mixtures that produce a lax effect. Also in the diet of a baby with irritable bowel syndrome should include puree from prunes, vegetable and fruit juices. This is necessary in order to regulate the urge to defecate.

Syndrome of irritable bowel in adolescent

In adolescence, the course of IBS is slightly different from that in children. The main difference is that adolescents for the most part begin to worry about extraintestinal symptoms. They are quite diverse, so the manifestations of the irritation syndrome of the digestive organ in them simply "drown".Most often, grown-up children complain of the following negative symptoms:

  • Adolescents with IBS have problems from the upper parts of the digestive organs: nausea, early satiety, a feeling of heaviness after eating, heartburn;
  • Children in puberty, especially girls suffering from irritable bowel syndrome, complain of rapid fatigue, palpitations, headaches. They may experience rapid urination in very small portions and drawing pains in the muscles;
  • The majority of grown-up children with irritable bowel syndrome have various neurotic disorders. Among them, most often in IBS, there are easy episodes of depression, during which the patient "withdraws" and loses interest in the world around him, and hypochondria. At the same time, patients become excessively demanding of others, obtrusive and capricious.

Treatment of irritable bowel syndrome in adolescents differs from that in infants. It is similar to that of adult patients. But the main point of treatment of IBS is the same as in newborns and babies. All activities are to change the diet. Reception of medicines is prescribed by a specialist rarely.

In the case when irritable bowel syndrome occurs in children accompanied by constipation, laxative preparations of lactulose, probiotics and prokinetics may be recommended. If diarrhea predominates, probiotic and antidiarrheal agents, enzymes, antiseptics and enterosorbents are shown. When treating children with mixed or unclassified variants of irritable bowel syndrome, carminative drugs, probiotics and antispasmodics are used. With IBS, psychotherapeutic correction is sometimes necessary. It is conducted according to the appointment of a specialist.

For hypermotor dysfunction of the gastrointestinal tract, children with irritable bowel syndrome can be given reflexotherapy, electrophoresis, paraffin, ozocerite or mud applications on the abdomen. In the case of hypomotor dyskinesia with IBS, anterior abdominal wall massage, electrostimulation and darsonvalization to the abdominal region are necessary. When, after carrying out tests aimed at detecting irritable bowel syndrome in children, signs of other diseases are also revealed, the child should be referred to a hospital for additional research and follow-up.

Differential diagnosis of IBS in children

In order to identify that a child develops this disease, it is necessary to conduct special studies to exclude organic or infectious diseases of the gastrointestinal tract. For this reason, differential diagnosis of irritable bowel syndrome should be performed in children. For its implementation, the following methods are used:

  • To determine the presence of IBS in a child, it is necessary to study the transit of stool mass through the large intestine. To do this, specialists use several methods of investigation: radionuclide, radiographic, radiotelemetric. The motor function of the digestive organ is revealed by means of computerized manometry, scintigraphy or enterocoloscintigraphy;
  • Differential diagnosis of irritable bowel syndrome in children also involves ultrasound examination of this digestive organ. It allows you to determine the size of the lumen in it, the thickness and layered structure of the wall, the severity of the mucosa and violation of the caustic;
  • It is used in the study of a child for the presence of it is IBS and endoscopy. This method can show ultrastructural changes in the mucosa that indicate the predominance of bacterial cells over epithelial and moderate fibrosis in the stroma.

The volume of research in children in each case of irritable bowel syndrome is determined individually. For this, it is necessary to take into account the history data. The carried out researches allow to exclude biochemical and organic disturbances in small patients. But in the case of a history of a child with IBS, there are signs such as gastrointestinal cancer in close relatives, unexplained weight loss, poor laboratory performance( blood in the feces, an increase in ESR, anemia) or manifestation of symptoms at night requires a more thorough examination. It will allow to determine that children have irritable bowel syndrome, and to exclude a possible tumor process or inflammatory diseases of the digestive tract.

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