Pediatric IBS can me managed conservatively by primary care physicians

January 01, 0001

Pediatric IBS can me managed conservatively by primary care physicians

The goal of these Italian investigators was to demonstrate that functional gastrointestinal disorders (FGIDs) such as irritable bowel syndrome can be diagnosed and managed by primary care physicians. A total of 9291 patients, aged birth to 14 years, were prospectively enrolled during a 3-month period by 21 physicians. Follow-up was performed at 1-, 3-, and 12-month intervals. Physicians in the study were asked to comply with the diagnostic/therapeutic protocol and record investigations and treatment prescribed.

The investigators found: "Two hundred sixty-one patients (2.8%) met Rome II criteria and were included in the study. In all cases but 4, diagnosis of FGIDs was confirmed at the end of follow-up (98.4%)… Among 56 patients treated only with the explanation of symptom and reassurance, 52 (92.8%) have reported success, in comparison with 26 of 35 patients (74.3%) treated with drugs (odds ratio: 4.5)."

The investigators concluded: "FGIDs can be diagnosed and managed in primary care. Prospective studies in primary care allow assessment of compliance of pediatricians and implementation of what is learned in courses developed in continuing medical education. Informed reassurance and availability of physicians are more useful than over-the-counter drugs, which are often used for FGIDs."

This study, though not a randomized controlled trial, suggest that IBS can be diagnosed and managed by primary care physicians without an undue reliance on medications.

For the full abstract, click here.

Pediatrics 125(1): e155-e161, January 2010 © 2010 to the American Academy of Pediatrics
Clinical Utility of Rome Criteria Managing Functional Gastrointestinal Disorders in Pediatric Primary Care. Giuseppe Primavera, Biagio Amoroso, Alba Barresi, et al.

Category: D. Digestive. Keywords: IBS, irritable bowel syndrome, pediatrics, primary care, Rome II criteria, open label non-randomized study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 10 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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