The Incidence of Irritable Bowel Syndrome in Children Using the Rome III Criteria and the Effect of Trimebutine Treatment

BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders and when compared to the vast knowledge pertaining to adults with IBS, very little is known about IBS in children and adolescents. We aimed to explore the prevalence of IBS, identify symptoms and contributing factors and also to examine the efficacy of trimebutine maleate in children and adolescents. METHODS: The study involved 345 children and adolescents (4-18 years) and parents were requested to fill in a questionnaire, Rome III criteria was used to diagnose IBS. To exclude organic disease, all patients underwent medical investigations. Half of the randomly selected IBS patients were treated with trimebutine maleate while the rest of IBS patients were not. The IBS patients were reevaluated at the end of 3 weeks. RESULTS: The prevalence of IBS according to Rome III criteria in children and adolescents was 22.6% and IBS with constipation was the predominant subtype. Back pain (OR, 6.68), headache (OR, 4.72) and chronic fatigue (OR, 3.74) were significantly higher in IBS group. The prevalence of IBS in both parents and depression in mothers was greater for the patient group than the healthy controls (P < 0.0001). The prevalence of functional dyspepsia in IBS group was 80.8% and was significantly higher than control group. Clinical recovery was seen in 94.9% of the trimebutine maleate group versus spontaneous recovery in 20.5% of the non-medicated group. The difference was significant (P < 0.0001). CONCLUSIONS: IBS is a common disorder in children and adolescents. IBS is closely associated with somatic and familial factors. Trimebutine maleate is effective for pediatric IBS patients.

effect of maternal anemia on anthropometric measurements of newborns

To evaluate the relation between maternal prenatal hemoglobin concentration and neonatal anthropometric measurements. All pregnant women who gave birth at the Obstetrics Department of Dr. LK Kartal Training and Research Hospital, Istanbul, Turkey, from January 1, 2005 to December 31, 2006, and their newborns were included in this prospective, cross-sectional study. The newborns' weight, height, head, and chest circumference were recorded. Mothers with hemoglobin concentration less than 11g/dl were evaluated as anemic. The anemic mothers were then grouped into 3 categories according to the corresponding hemoglobin concentration: mild [10.9-9.0g/dl], moderate [8.9-7.0 g/dl], and severe anemic [less than 7 g/dl]. The anthropometric measurements of newborns from non-anemic and anemic mother groups were compared. Of the 3688 pregnant women, 1588 [43%] were found to be anemic. Among the anemic mothers, 1245 had mild [78.5%], 311 had moderate [19.5%], and 32 [2%] had severe anemia. The anthropometric measurements [height, weight, head and chest circumference] of newborns of anemic and non-anemic mother groups showed a statistically significant difference [p=0.036, p=0.044, p=0.013, and p=0.0002]. There was a statistically significant difference in height, weight, and chest circumference of newborns of severe anemic and mild anemic mothers [p=0.017, p=0.008 and p=0.02]. The height [1.1 cm], weight [260 g], head [0.42 cm], and chest [1 cm] circumference of neonates in the severe anemic group is less than the mild anemic group. Anemia during pregnancy affect the anthropometric measurements of a newborn. Severe anemia had significant negative effect on neonatal anthropometric measurements