Irritable bowel syndrome in children: Pathogenesis, diagnosis and evidence-based treatment

Table 1 Rome III diagnostic criteria for childhood irritable bowel syndrome

Abdominal discomfort or pain associated with 2 or more of the following (present at least 25% of the time):

Improved after defecation

Onset of symptoms associated with a change in stool frequency

Onset associated with a change in stool form alternating between diarrhea and constipation

No evidence of an inflammatory, anatomic, metabolic, or neoplastic process that explains the child’s symptoms

The above criteria should be fulfilled at least once per week for at least 2 mo before a diagnosis of irritable bowel syndrome is made.

Table 2 Red flag symptoms

Night time pain or diarrhea

Recurrent unexplained fever

Recurrent or worsening rectal bleeding

Joint pains

History of weight loss and poor growth

Family history of inflammatory bowel disease

Persistence of severe vomiting or diarrhea

Unexplained pallor

Stools that may be difficult to flush away

Delay in onset or progression of puberty