Irritables Kolon bei Kindern

Irritable bowel syndrome (IBS) represents the most prevalent manifestation of functional gastrointestinal disorders in children and adolescents. It is characterized by recurrent abdominal pain or discomfort without evidence for organic disorders associated with defecation or alterations in stool frequency or stool form (diarrhea or constipation). The etiology of irritable bowel syndrome is multifactorial and complex. Genetic and familial factors together with stressful early life events and gastrointestinal infections may lead to mucosal inflammation, disturbances of intestinal motility and permeability. The diagnostic process consists of careful history and physical examination and simple investigations. Invasive procedures should be avoided whenever possible. Treatment of children and adolescents with IBS should be based on the biopsychosocial model of functional gastrointestinal disorders. Development of a positive relationship between pediatrician, child and parents is part of the therapeutic process. Cognitive-behavioral training as part of a multidisciplinary psychosocial intervention is recommended. Pharmacotherapy (probiotics, peppermint oil and macrogol) should be given only in selected cases.