Microsocial risk and protective factors for development of irritable bowel syndrome in children
DOI:
https://doi.org/10.15574/SP.2023.130.32Keywords:
children, irritable bowel syndrome, biopsychosocial model of medicine, microsocial factorsAbstract
Irritable bowel syndrome (IBS) is a stress-sensitive gastrointestinal disorder, which occurs as a result of the complex interaction of individual physiological, psychological and psychosocial factors. A tendency of IBS to cluster in families is caused not only by genetic predisposition but also by epigenetic mechanisms of psychosocial transmission of somatic symptoms from parents to children.
Purpose - to determine the role of certain microsocial risk factors in the development of IBS in children.
Materials and methods. The study involved 54 patients aged 6 to 12 years old with a diagnosis of IBS established in accordance with the Rome IV criteria, as well as 50 practically healthy children from the control group. For a detailed study of perinatal and microsocial risk factors and prevention of IBS, the developmental histories of children were analyzed and the «family history» method was used (descriptive and phenomenological collection of life history from the patient’s parents). Data were processed using Microsoft Excel 2016 and analyzed with GraphPad (Prism 5.0).
Results. Perinatal risk factors that can lead to the development of IBS in children are birth from the first in order of delivery, caesarean section, breastfeeding for less than 3 months. There is also a correlation between an increased risk of IBS in children and the presence of psychosomatic disorders in infants and young children, a tendency to somatization in the mother; the frequency of visits to doctors by the child and mother more than 6 times a year; authoritarian parenting style by the mother and hyperprotective parenting style by the father; frequent overeating and food intolerances. On the contrary, birth from a multigravid woman, absence of psychosomatic disorders of infants and toddlers, parental emotional warmth and democratic parenting may be protective of the development of IBS in children.
Conclusions. A number of microsocial factors have been identified that are associated with an increased risk of IBS. Awareness of those factors and consequently their correction may be important for the prevention of IBS in children.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Black CJ, Ford AC. (2020). Global burden of irritable bowel syndrome: trends, predictions and risk factors. Nature reviews. Gastroenterology & hepatology. 17 (8): 473-486. https://doi.org/10.1038/s41575-020-0286-8; PMid:32296140
Chogle A, Mintjens S, Saps M. (2014). Pediatric IBS: an overview on pathophysiology, diagnosis and treatment. Pediatric annals. 43 (4): e76-e82. https://doi.org/10.3928/00904481-20140325-08; PMid:24716562
Chung FF, Wan GH, Kuo SC, Lin KC, Liu HE. (2018). Mother-infant interaction quality and sense of parenting competence at six months postpartum for first-time mothers in Taiwan: a multiple time series design. BMC pregnancy and childbirth. 18 (1): 365. https://doi.org/10.1186/s12884-018-1979-7; PMid:30189849 PMCid:PMC6127995
Devanarayana, N. M., & Rajindrajith, S. (2018). Irritable bowel syndrome in children: Current knowledge, challenges and opportunities. World Journal Gastroenterology. 24 (21): 2211-2235. https://doi.org/10.3748/wjg.v24.i21.2211; PMid:29881232 PMCid:PMC5989237
Drossman D. A. (2016). Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. S0016-5085(16)00223-7. https://doi.org/10.1053/j.gastro.2016.02.032; PMid:27144617
Fu Y, Thomas R, Cares K. (2021). Influence of Family History on Children With Irritable Bowel Syndrome. Journal of pediatric gastroenterology and nutrition. 72 (6): 866-869. https://doi.org/10.1097/MPG.0000000000003059; PMid:33534363
Harvey PR, Theron B, Smith SCL, Rastall P, Steves CJ, Harris J et al. (2020). The association between low birth weight, childhood recollections of parental response to illness, and irritable bowel syndrome: a twin study. Neurogastroenterology & Motility. 32 (11): e13939. https://doi.org/10.1111/nmo.13939; PMid:32715594
Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tilburg M. (2016). Functional Disorders: Children and Adolescents. Gastroenterology. S0016-5085(16)00181-5. https://doi.org/10.1053/j.gastro.2016.02.015; PMid:27144632
Ilska M, Banaś E, Gregor K, Brandt-Salmeri A, Ilski A, Cnota W. (2020). Vaginal delivery or caesarean section - Severity of early symptoms of postpartum depression and assessment of pain in Polish women in the early puerperium. Midwifery. 87: 102731. https://doi.org/10.1016/j.midw.2020.102731; PMid:32403020
Jones MP, Faresjö Å, Beath A, Faresjö T, Ludvigsson J. (2020). Abdominal Pain in Children Develops With Age and Increases With Psychosocial Factors. Clinical gastroenterology and hepatology. 18(2): 360-367.e1. https://doi.org/10.1016/j.cgh.2019.04.036; PMid:31009796
Kim JH, Lee SW, Kwon Y, Ha EK, An J, Cha HR et al. (2022). Infantile Colic and the Subsequent Development of the Irritable Bowel Syndrome. Journal of neurogastroenterology and motility. 28 (4): 618-629. https://doi.org/10.5056/jnm21181; PMid:36250369 PMCid:PMC9577576
Knight JR, Locke GR 3, Zinsmeister AR, Schleck CD, Talley NJ. (2015). Family history of mental illness or alcohol abuse and the irritable bowel syndrome. Journal of psychosomatic research. 78 (3): 237-241. https://doi.org/10.1016/j.jpsychores.2014.11.021; PMid:25582802 PMCid:PMC4505618
Koloski NA, Jones M, Weltman M, Kalantar J, Bone C, Gowryshankar A et al. (2015). Identification of early environmental risk factors for irritable bowel syndrome and dyspepsia. Neurogastroenterology & Motility. 27 (9): 1317-1325. https://doi.org/10.1111/nmo.12626; PMid:26202154
Korterink JJ, Diederen K, Benninga MA, Tabbers MM. (2015). Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis. PloS one. 10 (5): e0126982. https://doi.org/10.1371/journal.pone.0126982; PMid:25992621 PMCid:PMC4439136
Liu S, Hagiwara SI, Bhargava A. (2017). Early-life adversity, epigenetics, and visceral hypersensitivity. Neurogastroenterology & Motility. 29 (9): e13170. https://doi.org/10.1111/nmo.13170; PMid:28782197 PMCid:PMC5576863
Low EXS, Mandhari MNKA, Herndon CC, Loo EXL, Tham EH, Siah KTH. (2020). Parental, Perinatal, and Childhood Risk Factors for Development of Irritable Bowel Syndrome: A Systematic Review. Journal of neurogastroenterology and motility. 26 (4): 437-446. https://doi.org/10.5056/jnm20109; PMid:32989183 PMCid:PMC7547188
Makker J, Chilimuri S, Bella JN. (2015). Genetic epidemiology of irritable bowel syndrome. World journal of gastroenterology. 21 (40): 11353-11361. https://doi.org/10.3748/wjg.v21.i40.11353; PMid:26525775 PMCid:PMC4616211
Martín-Calvo N, Goni L, Tur JA, Martínez JA. (2022). Low birth weight and small for gestational age are associated with complications of childhood and adolescence obesity: Systematic review and meta-analysis. Obesity reviews. 23 (1): e13380. https://doi.org/10.1111/obr.13380
Saito YA, Petersen GM, Larson JJ, Atkinson EJ, Fridley BL, de Andrade M et al. (2010). Familial aggregation of irritable bowel syndrome: a family case-control study. The American journal of gastroenterology. 105 (4): 833-841. https://doi.org/10.1038/ajg.2010.116; PMid:20234344 PMCid:PMC2875200
Semen MO, Lychkovska OL, Shymanska IE, Semen VD, Makukh HV. (2022). High frequency of the 472AA COMT (Val158) homozygous genotype of the catechol-O-methyltransferase (COMT) gene in children with irritable bowel syndrome. Modern Pediatrics. Ukraine. 6 (126): 23-29. https://doi.org/10.15574/SP.2022.126.23
Sjölund J, Uusijärvi A, Tornkvist NT, Kull I, Bergström A, Alm J et al. (2021). Prevalence and Progression of Recurrent Abdominal Pain, From Early Childhood to Adolescence. Clinical gastroenterology and hepatology. 19 (5): 930-938.e8. https://doi.org/10.1016/j.cgh.2020.04.047; PMid:32344151
Van Tilburg MA, Levy RL, Walker LS, Von Korff M, Feld LD, Garner M et al. (2015). Psychosocial mechanisms for the transmission of somatic symptoms from parents to children. World journal of gastroenterology. 21 (18): 5532-5541. https://doi.org/10.3748/wjg.v21.i18.5532; PMid:25987776 PMCid:PMC4427675
Videlock EJ, Adeyemo M, Licudine A, Hirano M, Ohning G, Mayer M et al. (2009). Childhood trauma is associated with hypothalamic-pituitary-adrenal axis responsiveness in irritable bowel syndrome. Gastroenterology. 137 (6): 1954-1962. https://doi.org/10.1053/j.gastro.2009.08.058; PMid:19737564 PMCid:PMC2789911
Waehrens R, Li X, Sundquist J, Sundquist K, Zöller B. (2018). Perinatal and familial risk factors for irritable bowel syndrome in a Swedish national cohort. Scandinavian journal of gastroenterology. 53 (5): 559-566. https://doi.org/10.1080/00365521.2017.1398345; PMid:29124972
Xing Z, Hou X, Zhou K, Qin D, Pan W. (2014). Impact of parental-rearing styles on irritable bowel syndrome in adolescents: a school-based study. Journal of gastroenterology and hepatology. 29 (3): 463-468. https://doi.org/10.1111/jgh.12388; PMid:24117871
Zeevenhooven J, Rutten JMTM, van Dijk M, Peeters B, Benninga MA. (2019). Parental Factors in Pediatric Functional Abdominal Pain Disorders: A Cross-sectional Cohort Study. Journal of pediatric gastroenterology and nutrition. 68 (2): e20-e26. https://doi.org/10.1097/MPG.0000000000002163; PMid:30289821
Zhao XH, Zhang ZH. (2020). Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses. Asian journal of psychiatry. 53: 102353. https://doi.org/10.1016/j.ajp.2020.102353; PMid:32927309
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Modern pediatrics. Ukraine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
