Family History of IBS Linked to Psychological Disorder in Pediatric Patients With IBS

Children with irritable bowel syndrome (IBS) who have a family history of IBS (FH-IBS) are likely to have underlying psychological disorders and to have received psychological interventions. These findings were reported in a study published in the Journal of Pediatric Gastroenterology and Nutrition.

Although people with IBS are known to be at increased risk for anxiety and depression, few studies to date have focused on the influence of family history on children with IBS. To address this gap, a group of investigators from the Children’s Hospital of Michigan conducted a retrospective study from January 2009 to December 2018. This study compares the clinical profile of children with FH-IBS and the differences in their management with that of those without FH-IBS.

Researchers identified participants for the study having an IBS diagnosis according to the International Classification of Diseases (ICD)-9 564.1 or ICD-10 K58. They collected data on initial and ongoing IBS management, including dietary modification and the use of supplements and medications, as well as psychological intervention. An analysis of this data was conducted using IBM SPSS Statistics (version 26.0, Chicago, IL). They classified participants with relatives diagnosed with IBS within 3 generations as having a positive family history.

Of the 251 pediatric patients (range, 1-18 years of age) with IBS who were enrolled in the study, 75 (30%) had FH-IBS and 176 (70%) did not.

The researchers found no significant differences between the two groups regarding sex composition, age at initial visit, age of IBS diagnosis, dietary modifications, or use of supplements, laxatives, antispasmodics, antidiarrheals, and cyproheptadine.

Children with FH-IBS when compared with children with IBS but not FH-IBS had a higher incidence of psychological comorbidities (41% vs 23%; P =.003) and were more likely to receive psychological counseling (49% vs 23%; P <.001) as well as antidepressant treatment (36% vs 15%, P <.001).

This study was limited by its retrospective design, which may have resulted in sample bias. In addition, the inclusion of data from a single center may result in potential geographic and/or racial bias. Lastly, the data from the tertiary care center and the patient population seen here may not be generalizable to other populations.  

According to the data, pediatric patients with FH-IBS are significantly more likely to have underlying psychological disorders and to receive psychological interventions. These findings highlight the importance of mental health screening and effective treatment for managing these comorbidities in pediatric patients with FH-IBS.

According to the study authors, “The pathophysiology of the correlation between IBS and psychological distress is not fully understood. However, visceral hypersensitivity is considered to be related to children’s mental disturbance.”

Reference

Fu Y, Thomas R, Cares K. Influence of family history on children with irritable bowel syndrome. J Pediatr Gastroenterol Nutr. Published online January 28, 2021. doi:10.1097/MPG.0000000000003059