A cross-sectional study of risk factors for irritable bowel syndrome in children 8-13 years of age in suzhou, china

Effects of neuroticism on pre-exam irritable bowel syndrome in female middle school students: mediating role of intolerance of uncertainty and moderating role of exercise duration

Background

China, which is deeply influenced by Confucianism, places special emphasis on students' test scores. Previous studies have shown that neuroticism is associated with irritable bowel syndrome (IBS) in adolescents. However, the mechanisms underlying this association before exams in female secondary school students are unknown. The present study sought to ascertain whether IU mediates the association between neuroticism and pre-exam IBS, and to determine whether exercise duration moderates the relationship between neuroticism and pre-exam IBS.

Methods

The sample consisted of 685 Chinese female middle school students (Mage = 14.81, SD = 1.55, range = 11-18) who completed paper questionnaires, including the neuroticism subscale of the Chinese Neuroticism Extraversion Openness Five-Factor Inventory, the IBS Symptom Severity Scale, a simplified version of the Intolerance of Uncertainty Scale, and a movement time questionnaire. Independent samples t-test was used to compare differences between groups and Pearson correlation coefficient was used to investigate the bivariate correlation. The SPSS PROCESS 4.1 plug-in was then used to examine the mediating role of IU as well as the moderating role of movement time between neuroticism and pre-exam IBS.

Results

Neuroticism and IU were significantly correlated with pre-exam IBS (r = 0.39, 0.30, respectively; all p < 0.01), and neuroticism was significantly correlated with IU (r = 0.46, p < 0.01). Neuroticism had a direct predictive effect on pre-exam IBS in Chinese female middle school students (β = 0.32, p < 0.001), and IU also had a positive effect on pre-exam IBS (β = 0.15, p < 0.001). The mediating effect value of IU on the total effect was 18.09%. The relationship between neuroticism and pre-exam IBS was moderated by movement time (β = -0.23, p < 0.05).

Conclusion

IU plays a mediating role between neuroticism and pre-exam IBS, and exercise time plays a moderating role between neuroticism and pre-exam IBS. These findings provide an evidence for neuroticism intervention, IU management, and pre-exam IBS improvement in female middle school students.

Prevalence and pattern of functional gastrointestinal disorders among secondary school adolescents in Lagos, Nigeria

BACKGROUND

Limited data exist on functional gastrointestinal disorders (FGIDs) among sub-Saharan African children. This study aimed to determine FGID prevalence and pattern among secondary school adolescents in Lagos, Nigeria.

METHODS

This descriptive cross-sectional study was conducted among adolescents aged 10-18 years in Isolo, Lagos, Nigeria from December 2020 to March 2021. A multi-stage sampling technique was used to select a total of 696 students from four secondary schools. Data were collected using a specifically designed questionnaire, the ROME IV questionnaire (QPGS-IV), and analyzed using the Statistical Package for the Social Sciences (SPSS) version 24.

RESULTS

The mean age of the adolescents was 13.6 ± 2.1. A total of 221 (31.8%) adolescents fulfilled the criteria for at least one of the FGIDs. The most common FGIDs were functional constipation (10.1%), functional dyspepsia (9.4%) and abdominal migraine (8.6%). There was no significant difference in the overall prevalence of FGIDs between age groups (p = 0.07) and genders (p = 0.949). However, the prevalence of FGID sub-types showed that abdominal migraine, irritable bowel syndrome and functional non-retentive fecal incontinence were significantly higher in the age group 10-12 years (p = 0.045, p = 0.029 and p = 0.027, respectively) while only functional vomiting was significantly higher in male compared to female (p = 0.038).

CONCLUSION

FGIDs are common among adolescents in Lagos, Nigeria. The pattern of FGIDs shows similarities and differences with reports from other parts of the world. Healthcare workers must be aware of these disorders to provide optimal care.

Early life adverse exposures in irritable bowel syndrome: new insights and opportunities

Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder worldwide. Extensive research has identified multiple factors contributing to its development, including genetic predisposition, chronic infection, gut dysbiosis, aberrant serotonin metabolism, and brain dysfunction. Recent studies have emphasized the critical role of the early life stage as a susceptibility window for IBS. Current evidence suggests that diet can heighten the risk of IBS in offspring by influencing the microbiota composition, intestinal epithelium structure, gene expression, and brain-gut axis. The use of antibiotics during pregnancy and the neonatal period disrupts the normal gut microbiota structure, aligning it with the characteristics observed in IBS patients. Additionally, early life stress impacts susceptibility to IBS by modulating TLR4, NK1, and the hypothalamic-pituitary-adrenal (HPA) axis while compromising the offspring's immune system. Formula feeding facilitates the colonization of pathogenic bacteria in the intestines, concurrently reducing the presence of probiotics. This disruption of the Th1 and Th2 cell balance in the immune system weakens the intestinal epithelial barrier. Furthermore, studies suggest that delivery mode influences the occurrence of IBS by altering the composition of gut microbes. This review aims to provide a comprehensive summary of the existing evidence regarding the impact of adverse early life exposures on IBS during pregnancy, intrapartum, and neonatal period. By consolidating this knowledge, the review enhances our understanding of the direct and indirect mechanisms underlying early life-related IBS and offers new insights and research directions from childhood to adulthood.

Irritable bowel syndrome in China: a review on the epidemiology, diagnosis, and management

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease worldwide. Current guidelines of IBS are mostly based on the western populations and expected to vary in different communities. China has a large population and a vast literature is available on IBS. Due to linguistic variations in the literature, the studies are not widely known and their conclusions thus remain largely obscured to the western medical literature. In this article, we reviewed the published literatures on the investigations of IBS epidemiology, diagnosis, and management in the Chinese population and emphasized the different findings gleaned from the western publications. The detailed literature review will benefit understanding of and promote future study on IBS.

Sex-Bias in Irritable Bowel Syndrome: Linking Steroids to the Gut-Brain Axis

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is more common in females. Despite its high global incidence, the disease mechanism is still unclear and therapeutic options remain limited. The sexual dimorphism in IBS incidence suggests that sex steroids play a role in disease onset and symptoms severity. This review considers sex steroids and their involvement in IBS symptoms and the underlying disease mechanisms. Estrogens and androgens play important regulatory roles in IBS symptomology, including visceral sensitivity, gut motility and psychological conditions, possibly through modulating the gut-brain axis. Steroids are regulators of hypothalamic-pituitary-adrenal activity and autonomic nervous system function. They also modulate gut microbiota and enteric nervous systems, impacting serotonin and mast cell signaling. Sex steroids also facilitate bidirectional cross-talk between the microbiota and host following bacterial transformation and recycling of steroids by the intestine. The sex-specific interplay between sex steroids and the host provides neuroendocrinology insight into the pathophysiology, epigenetics and treatment of IBS patients.

Functional abdominal pain disorders and asthma: two disorders, but similar pathophysiology?

INTRODUCTION

Functional abdominal pain disorders (FAPDs) and asthma are common ailments affecting both children and adults worldwide. Multiple studies have demonstrated an association between these two disorders. However, the exact reason for this observed association is not apparent.

AREAS COVERED

The current review has explored available literature and outlined multiple underlying pathophysiological mechanisms, common to both asthma and FAPDs, as possible reasons for this association.

EXPERT OPINION

Smooth muscle dysfunction, hypersensitivity and hyper-responsiveness, mucosal inflammation, and barrier dysfunction involving gastrointestinal and respiratory tracts are the main underlying pathophysiological mechanisms described for the generation of symptoms in FAPDs and asthma. In addition, alterations in neuroendocrine regulatory functions, immunological dysfunction, and microbial dysbiosis have been described in both disorders. We believe that the pathophysiological processes that were explored in this article would be able to expand the mechanisms of the association. The in-depth knowledge is needed to be converted to therapeutic and preventive strategies to improve the quality of care of children suffering from FAPDs and asthma.

Elimination of Fermentable Carbohydrates to Reduce Gastrointestinal Symptoms in Pediatric Patients With Irritable Bowel Syndrome: A Narrative Review

Irritable bowel syndrome (IBS) is classified as a functional gastrointestinal (GI) disorder characterized by abdominal pain, bloating, and changes in bowel function. Although the pathophysiology of IBS is incompletely understood, fermentable carbohydrates are implicated as a potential cause of symptoms. An elimination diet, such as a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, represents a potential intervention for reducing GI symptoms in patients with IBS. The role of fermentable carbohydrates in symptom onset is well studied in adult patients with IBS; however, less research exists in the pediatric population. This review sought to explore evidence for the role of dietary fermentable carbohydrate elimination to reduce GI symptoms (abdominal pain, stool changes, abdominal bloating) in children and adolescents (4-19 years of age) diagnosed with IBS based on Rome III or IV criteria. Five studies of neutral to positive quality rating were identified and analyzed using the Academy of Nutrition and Dietetics Evidence Analysis Process. These studies demonstrate that dietary elimination of fermentable carbohydrates, such as through a low-FODMAP diet, reduces the severity of 1 or more GI symptoms in about one-quarter to one-half of pediatric patients with IBS. Patients without improvement are considered "nonresponders" and may require an alternative intervention. More research is needed to establish the best way to identify patients who would respond to elimination diets vs other IBS treatment strategies.

Gut microbiome pattern in adolescents with functional gastrointestinal disease

BACKGROUND

Functional gastrointestinal disease (FGID) has a worldwide prevalence of 10-45%, and is one of the most common causes of recurrent abdominal pain in children. FGID is characterized with abdominal discomfort and changes in bowel movement. Alteration in gut microbiota is associated with FGID, but data are limited, and there are no data from Indonesia.

METHODS

A case-control study was conducted in 22 FGID children and 28 healthy subjects aged 13-18 years at the junior high school and senior high school in Central Jakarta. FGID was diagnosed using Rome IV criteria. Age, sex, and level of education were recorded. Stool samples were collected and investigated for Bifidobacterium spp. and Enterobacteriaceae.

RESULTS

Most of the FGID subjects were females (17/22), with a median age of 16 years. The median values of Bifidobacterium spp. were 138.95 (range: 0.2-22,735.8) CFU/gram for the FGID subjects and 232.5 (range: 1.9-38,985.6) CFU/gram in healthy subjects, which showed no statistically significant difference (P = .49). The median values of Enterobacteriaceae were 58.9 (range: 2.5-9577.8) CFU/gram in FGID subjects and 85 (range: 12.1-3139.4) CFU/gram in healthy subjects, which showed no statistically significant difference (P = .94). Our findings indicate that the gut microbiome of adolescents with FGIDs is characterized by a huge variability in levels of Bifidobacterium spp. and Enterobacteriaceae.

CONCLUSION

Because of the wide range detected in the number of Bifidobacterium spp. and Enterobacteriaceae in FGID and healthy subjects, no statistically significant difference was observed. More studies in larger groups of selected patients may be needed.

Irritable bowel syndrome in children: Current knowledge, challenges and opportunities

Irritable bowel syndrome (IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS.

Dietary behaviors in relation to prevalence of irritable bowel syndrome in adolescent girls

BACKGROUNDS AND AIMS

There is limited evidence regarding the relationship between dietary behaviors and irritable bowel syndrome (IBS). This study aimed to explore the association between diet-related practices and prevalence of IBS.

METHODS

The study was conducted among 988 adolescent girls living in Iran. Dietary behaviors were pre-defined and assessed in nine domains using a pre-tested questionnaire. To investigate the association between diet-related practices and the presence of IBS, this study used logistic regression analysis in crude and adjusted models.

RESULTS

The prevalence of IBS was 16.9% in this population. Compared with individuals who did not consume fluid with their meal, those who always consumed fluid with meals had a greater chance of IBS (odds ratio [OR]: 2.91; P: 0.01). This study found a direct relationship between a greater intake of spicy food and IBS prevalence (OR: 5.28; P: 0.02). The individuals who ate fried foods every day also had a greater risk of IBS compared with those who did not consume fried foods (OR: 1.65; P: 0.01). The subjects who had lost ≥ 5 teeth had 2.23 times greater odds for IBS than the individual who had lost ≤ 1 tooth (OR: 2.23; P: 0.01) was a significant inverse relationship between the chewing sufficiency and the risk of IBS (OR: 4.04; P: 0.02). These associations remained significant after controlling for potential confounder.

CONCLUSIONS

Intra-meal fluid intake, chewing insufficiency, higher tooth loss, and the consumption of spicy and fried food were associated with increased risk of IBS. Prospective studies are needed to confirm these findings.

Irritable bowel syndrome in adolescents in Lagos

INTRODUCTION

irritable bowel syndrome (IBS) is one of the functional gastrointestinal disorders (FGIDs) which has been well described in western populations especially as the commonest cause of recurrent abdominal pain The aim of this study was to document the prevalence of Irritable bowel syndrome (IBS) amongst children in western Nigeria and increase the aware ness of IBS amongst physicians who manage children with abdominal pain.

METHODS

This was a cross-sectional study conducted amongst children aged 10-18 years in 8 schools located in two local government areas of Lagos state. A multistage stratified random-sampling survey was conducted using the validated Rome III criteria to assess for IBS and associated risk factors. The subtypes of IBS and associated extra-intestinal symptoms were also documented.

RESULTS

The prevalence of IBS was 16.0% in the study participants and the prevalence decreased with increasing age (p=0.05). Sixty two (62.5%) of the students with recurrent abdominal pain had IBS. IBS was more prevalent in the females compared to the males (p=0.000). The significant risk factors for IBS identified were gender (p=0.000), socioeconomic status (p=0.001) and past history of gastroenteritis (p=0.011). The commonest subtype of IBS seen was the alternating subtype.

CONCLUSION

IBS is prevalent in African children. Physicians who attend to children need to have a high index of suspicion for IBS in children who present with abdominal pain when there are no alarm symptoms. The need for further longitudinal studies in African children cannot be overemphasized.

Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place

Irritable bowel syndrome (IBS), a common gastrointestinal disorder involving the gut-brain axis, and inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder, are both increasing in incidence and prevalence in Asia. Both have significant overlap in terms of symptoms, pathophysiology, and treatment, suggesting the possibility of IBS and IBD being a single disease entity albeit at opposite ends of the spectrum. We examined the similarities and differences in IBS and IBD, and offer new thoughts and approaches to the disease paradigm.

Epidemiology of irritable bowel syndrome in children and adolescents in Asia

OBJECTIVES

Several cross-sectional surveys have been conducted to study the prevalence of irritable bowel syndrome (IBS) in children. The aim of the present study was to conduct a systematic review and a meta-analysis of published literature to estimate the prevalence of IBS among Asian children.

METHOD

A computer-assisted search of MEDLINE, EMBASE, PsycINFO, and regional databases of Asia was carried out. Selected articles were reviewed in depth and data were extracted. Pooled prevalence, sex differences, and 95% confidence intervals were calculated. Heterogeneity of the studies was assessed using the I(2) test.

RESULTS

A total of 16 cross-sectional studies that reported prevalence of IBS (in children and adolescents) and qualified to be included were taken into the final analysis containing 38,076 patients. Selected studies are from China, Korea, Japan, Iran, Sri Lanka, and Saudi Arabia. Studies showed a marked heterogeneity with I(2) of 98.59 (P < 0.0001). Prevalence of IBS ranges from 2.8% to 25.7%, with a pooled prevalence of 12.41% (95% confidence interval 9.87-14.95). Prevalence risk ratio of girl:boy is 1.39. Prevalence of subtypes is diverse and varies between studies.

CONCLUSIONS

The published data indicate that IBS is a significant problem among Asian children and adolescents. Female sex predisposes children and adolescents to develop IBS.

Bacterial infections in childhood: A risk factor for gastrointestinal and other diseases?

BACKGROUND

There is evidence for post-infectious irritable bowel syndrome (PI-IBS) in adults, but little is known about PI-IBS in children. The nationwide representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS) assessed children's health.

OBJECTIVE AND METHODS

We identified 643 children (50.1% males) in the KiGGS cohort (N = 15,878, 51% males) with a history of Salmonella infection. The number was validated comparing this group with the known infection statistics from the Robert Koch-Institute registry. We compared this group to the remaining KiGGS cohort (n = 12,951) with respect to sociodemographic characteristics, pain and quality of life. To check for specificity, we repeated the comparisons with a group with a history of scarlet fever.

RESULTS

Infection statistics predicted 504 cases of Salmonella infection in the KiGGS cohort, indicating high validity of the data. In children between 3 and 10 years with a history of Salmonella infection, significantly more abdominal pain (31.7% versus 21.9%, p < 0.001) and headache (27.2% versus 15.1%, p < 0.001) were reported. This group showed lower quality of life (p < 0.001). Comparison to a group of scarlet fever-infected children revealed poor specificity of the data.

CONCLUSION

Differences found between children with and without Salmonella infection reveal the role of gastrointestinal infection in the development of post-infectious abdominal problems, but poor specificity may point toward a psychosocial ("somatization") rather than a Salmonella-specific mechanism.

A school-based study of irritable bowel syndrome in medical students in beijing, china: prevalence and some related factors

Purpose. To investigate the prevalence and some related factors about irritable bowel syndrome (IBS) in medical students. Methods. A cross-sectional study was carried out from February 2014 to Jun 2014 in Beijing University of Chinese Medicine, Beijing, China. All participants were asked to completed self-administered questionnaires. Results. Seven hundred and sixty-seven medical students (23.26 ± 2.88 years, 25.6% males) completed the survey. The prevalence of IBS was 33.3%, with a high prevalence in women (36.1%). Among the IBS patients, 112 cases were IBS-M (43.9%) and 77.6% had moderately severe IBS. There were no statistical differences between control group and IBS patients in anxiety and depression scores (P > 0.05). The total score of Pittsburgh sleep quality index (PSQI) was significantly higher for medical students with IBS and 35.5% of IBS patients had severe sleep disorder; the scores of child trauma questionnaire (CTQ) and student-life stress inventory (SLSI) were also higher in IBS patients. Sex and sleep disorder were independently associated with IBS (OR, 1.914, 95%CI, 1.281-2.860; OR, 1.143, 95%CI, 1.074-1.216). Conclusion. Our study has many valuable findings and they may provide valuable suggestions for the necessary intervention and treatment measures towards medical students.