The Role of Fiber in the Treatment of Functional Gastrointestinal Disorders in Children.

Cara Axelrod,Miguel Saps

doi:10.3390/nu10111650

Cara Axelrod, Miguel Saps

Open Access

https://doi.org/10.3390/nu10111650

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Journal: Nutrients	Publication Date: Nov 3, 2018
Citations: 39	License type: CC BY 4.0

Affiliation: University of Miami

Abstract

We reviewed the available evidence on the role of fiber in the treatment of Functional Constipation (FC) and Irritable Bowel Syndrome (IBS) in children. The vast majority of toddlers and preschoolers do not consume enough fiber. Two of the most common reasons for consultation to a pediatric gastroenterology practice include FC and IBS. The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines state that the evidence does not support the use of fiber supplements in the treatment of FC in children, and the Rome IV criteria do not recommend an increase in fiber consumption, in children with IBS. Despite this, in general practice, it is commonly recommended that children who experience constipation and IBS to increase their fiber intake. We conducted a systematic review of the available evidence on the role of fiber in the treatment of FC and IBS in children. Thirteen full-text articles with a total of seven hundred and twenty-three pediatric participants were included in this review. Three clinical trials found positive effects of dietary fiber for the management of IBS. Nine out of ten trials found fiber to be either more effective than placebo, or just as effective as laxative treatment. Most studies on the use of fiber for the treatment of FC and IBS have shown its benefit. However, due to the heterogeneity in study design, length of treatment, outcome measures, and amount and type of fiber, we were unable to make a definitive recommendation supporting the use of fiber for the treatment of FC and IBS in children.

Highlights

The Rome IV criteria classifies functional gastrointestinal disorders (FGIDs) in the disorders of nausea and vomiting, disorders of defecation (functional constipation (FC) and functional non-retentive fecal incontinence) and functional abdominal pain disorders (irritable bowel syndrome (IBS), functional dyspepsia, abdominal migraine, and functional abdominal pain not otherwise specified) [1].FGIDS in children is a public health problem
Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines state that the evidence does not support the use of fiber supplements in the treatment of Functional Constipation (FC) in children, and the Rome IV criteria do not recommend an increase in fiber consumption, in children with Irritable Bowel Syndrome (IBS)
Due to the heterogeneity in study design, length of treatment, outcome measures, and amount and type of fiber, we were unable to make a definitive recommendation supporting the use of fiber for the treatment of FC and IBS in children

Summary

Introduction

The Rome IV criteria classifies functional gastrointestinal disorders (FGIDs) in the disorders of nausea and vomiting, disorders of defecation (functional constipation (FC) and functional non-retentive fecal incontinence) and functional abdominal pain disorders (irritable bowel syndrome (IBS), functional dyspepsia, abdominal migraine, and functional abdominal pain not otherwise specified) [1]. FGIDS in children is a public health problem. One in sixteen school-age children are diagnosed with IBS [2], most of them have IBS with constipation (IBS-C) [3]. FGIDs are associated with anxiety and lower health-related quality of life in physical, social, emotional, and school functioning [5]. IBS and FC are among the most common reasons for consultation with pediatric gastroenterology [6]

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Discussion

Conclusion