Management of children with irritable bowel syndrome in general practice – a systematic review

INTRODUCTION: Irritable bowel syndrome (IBS) is the most frequently reported paediatric functional abdominal pain disorder (FAPD). It impacts quality of life, contributes to school absenteeism and can result in chronic pain. This review investigated the management of children with IBS in general practice regarding diagnostic evaluation, use of the Rome Criteria, diagnostic outcomes, referrals, prescriptions and follow-ups. METHODS: A systematic review was conducted following the PRISMA guidelines. Studies were identified through a structured PubMed search and screened using predefined inclusion criteria. Eligible studies focused on general practitioners' management of children with episodic abdominal pain, in which IBS could be a subtype. Data were reported narratively due to heterogeneity across studies. RESULTS: Five observational studies involving over 4,300 children were included. The proportion of children receiving a functional diagnosis ranged from 16% to 84%, and the Rome Criteria were rarely used (7-27% of cases). Blood and urine tests were commonly used. Prescriptions and referrals differed across studies. Follow-up was rare. CONCLUSIONS: IBS is the most common FAPD in children. Though often managed by general practitioners, it remains unclear how they diagnose and treat these cases. The Rome Criteria appear to be rarely used, and diagnosis frequency varies, suggesting some children may be overlooked or misclassified. Follow-up is infrequent, and it is unclear whether a biopsychosocial approach is used. More research is needed to understand and improve care in this setting.