Small study: Watchful waiting better for pediatric IBS

 

Children with irritable bowel syndrome (IBS) may recover more successfully with reassurance than with medication, according to a study from Federico II University in Naples, Italy.

Of 83 children in this single-center observational study, 30 of the 48 children (62.8%) who reported symptom resolution were not put on medication, according to Eleonora Giannetti, MD, and her colleagues (J Pediatr. 2017 Jan 18. doi: 10.1016/j.jpeds.2016.12.036).

Zerbor/Thinkstock

IBS with constipation was the most prevalent subtype (34 patients or 41%); IBS with diarrhea and IBS with alternating symptoms were reported in 26 (31.3%) and 23 (27.7%) children, respectively.

Researchers assessed children using a symptom survey, having patients and their parents report “how often days off school or interruption of daily activities because of IBS were needed,” as well as a scale of disruption ranging from 0 to 4.

A total of 47 children received verbal reassurance only, with no medication, while 9 received polyethylene glycol, 24 received probiotics, and 3 received trimebutine (not available in the United States), according to Dr. Giannetti.

Dr. Giannetti and her colleagues argued the data showed not only a positive correlation between decreased symptoms and lack of pharmaceutical intervention, but a negative impact of medication on children with IBS.

“Despite larger interventional studies being needed, our results also seem to suggest that traditionally prescribed medications, particularly probiotics and [polyethlene glycol], poorly affect the progression of IBS symptoms,” Dr. Giannetti wrote. “There was even a trend toward worse outcome of patients receiving probiotics.”

Limitations included a small sample size and medication not being randomly allocated.

Researchers said they also were limited by a short time frame, which, in regards to the “recurrent nature” of IBS, makes it difficult for researchers to know if and when IBS is completely resolved.

[email protected]

On Twitter @EAZtweets

 

Children with irritable bowel syndrome (IBS) may recover more successfully with reassurance than with medication, according to a study from Federico II University in Naples, Italy.

Of 83 children in this single-center observational study, 30 of the 48 children (62.8%) who reported symptom resolution were not put on medication, according to Eleonora Giannetti, MD, and her colleagues (J Pediatr. 2017 Jan 18. doi: 10.1016/j.jpeds.2016.12.036).

Zerbor/Thinkstock

IBS with constipation was the most prevalent subtype (34 patients or 41%); IBS with diarrhea and IBS with alternating symptoms were reported in 26 (31.3%) and 23 (27.7%) children, respectively.

Researchers assessed children using a symptom survey, having patients and their parents report “how often days off school or interruption of daily activities because of IBS were needed,” as well as a scale of disruption ranging from 0 to 4.

A total of 47 children received verbal reassurance only, with no medication, while 9 received polyethylene glycol, 24 received probiotics, and 3 received trimebutine (not available in the United States), according to Dr. Giannetti.

Dr. Giannetti and her colleagues argued the data showed not only a positive correlation between decreased symptoms and lack of pharmaceutical intervention, but a negative impact of medication on children with IBS.

“Despite larger interventional studies being needed, our results also seem to suggest that traditionally prescribed medications, particularly probiotics and [polyethlene glycol], poorly affect the progression of IBS symptoms,” Dr. Giannetti wrote. “There was even a trend toward worse outcome of patients receiving probiotics.”

Limitations included a small sample size and medication not being randomly allocated.

Researchers said they also were limited by a short time frame, which, in regards to the “recurrent nature” of IBS, makes it difficult for researchers to know if and when IBS is completely resolved.

[email protected]

On Twitter @EAZtweets

 

Children with irritable bowel syndrome (IBS) may recover more successfully with reassurance than with medication, according to a study from Federico II University in Naples, Italy.

Of 83 children in this single-center observational study, 30 of the 48 children (62.8%) who reported symptom resolution were not put on medication, according to Eleonora Giannetti, MD, and her colleagues (J Pediatr. 2017 Jan 18. doi: 10.1016/j.jpeds.2016.12.036).

Zerbor/Thinkstock

IBS with constipation was the most prevalent subtype (34 patients or 41%); IBS with diarrhea and IBS with alternating symptoms were reported in 26 (31.3%) and 23 (27.7%) children, respectively.

Researchers assessed children using a symptom survey, having patients and their parents report “how often days off school or interruption of daily activities because of IBS were needed,” as well as a scale of disruption ranging from 0 to 4.

A total of 47 children received verbal reassurance only, with no medication, while 9 received polyethylene glycol, 24 received probiotics, and 3 received trimebutine (not available in the United States), according to Dr. Giannetti.

Dr. Giannetti and her colleagues argued the data showed not only a positive correlation between decreased symptoms and lack of pharmaceutical intervention, but a negative impact of medication on children with IBS.

“Despite larger interventional studies being needed, our results also seem to suggest that traditionally prescribed medications, particularly probiotics and [polyethlene glycol], poorly affect the progression of IBS symptoms,” Dr. Giannetti wrote. “There was even a trend toward worse outcome of patients receiving probiotics.”

Limitations included a small sample size and medication not being randomly allocated.

Researchers said they also were limited by a short time frame, which, in regards to the “recurrent nature” of IBS, makes it difficult for researchers to know if and when IBS is completely resolved.

[email protected]

On Twitter @EAZtweets