Abstract
Background
Adults with irritable bowel syndrome (IBS) frequently identify foods as exacerbating
their gastrointestinal symptoms. In children with IBS, the prevalence of perceived
food intolerances and their impact are unknown.
Objective
Our aim was to determine the prevalence of self-perceived food intolerances and the
relationship of these intolerances to abdominal pain, psychosocial distress, and quality
of life in children with IBS.
Design
We conducted a cross-sectional study. Questionnaire and prospective diary data were
collected from 2008 to 2014 by trained research coordinators.
Participants/setting
Participants were children 7 to 18 years old (pediatric Rome III IBS, n=154; age-sex
matched healthy children, n=32) in Houston, TX.
Measures
Perceived food intolerances and avoided foods were captured using the Childhood Food
and Symptom Association Questionnaire. IBS severity was assessed by a ≥7-day pain
diary and validated psychosocial questionnaires assessing quality of life, somatization,
functional disability, depression, and anxiety.
Statistical analyses performed
We used descriptive Spearman bivariate correlation, χ2, and Poisson log-linear generalized model with Wald χ2 statistics.
Results
A greater proportion of children with IBS (143 of 154 [92.9%]) vs healthy children
(20 of 32 [62.5%]) identified at least one self-perceived food intolerance (χ2=22.5; P<0.001). Children with IBS identified a greater number (median=4 [25% to 75% quartile=2
to 6]) of perceived symptom-inducing foods than healthy children (median=2 [25% to
75% quartile=0 to 4]; χ2=28.6; P<0.001). Children with IBS avoided more foods (median=2 [25% to 75% quartile=1 to
4]) than healthy children (median=0 [25% to 75% quartile=0 to 2.75]; χ2=20.8; P<0.001). The number of self-perceived food intolerances was weakly associated (r value range= −0.17 to 0.21) with pain frequency, pain severity, somatization, anxiety,
functional disability, and decreased quality of life.
Conclusions
Children with IBS have a high prevalence of self-perceived food intolerances. The
number of these intolerances is weakly associated with measures of IBS severity.
Keywords
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Biography
B. P. Chumpitazi is an assistant professor, Department of Pediatrics, Baylor College of Medicine, Houston, TX; and director, Neurogastroenterology and Motility Program, Texas Children’s Hospital, Section of Gastroenterology, Hepatology, and Nutrition, Houston.
Biography
E. M. Weidler is a senior research coordinator, Department of Pediatrics, Baylor College of Medicine, Houston, TX; senior research coordinator, Children’s Nutrition Research Center, Houston, TX; and senior research coordinator, Texas Children’s Hospital, Section of Gastroenterology, Hepatology, and Nutrition, Houston.
Biography
D. Y. Lu is a research coordinator, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
Biography
C. M. Tsai is a research coordinator, Department of Pediatrics, Baylor College of Medicine, Houston, TX; and research coordinator, Texas Children’s Hospital, Section of Gastroenterology, Hepatology, and Nutrition, Houston.
Biography
R. J. Shulman is a professor, Department of Pediatrics, Baylor College of Medicine, Houston, TX; professor, Children’s Nutrition Research Center, Houston, TX; and attending physician, Texas Children’s Hospital, Section of Gastroenterology, Hepatology, and Nutrition, Houston.
Article info
Publication history
Published online: June 15, 2016
Accepted:
April 26,
2016
Received:
July 10,
2015
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST B. P. Chumpitazi receives funding from the National Institutes of Health (NIH), QOL Medical Inc, and is a consultant for Mead Johnson Nutrition. R. J. Shulman receives funding from the NIH and Mead-Johnson Inc, and is a consultant for Nutrinia Inc and Gerson Lehrman Group. No potential conflict of interest was reported by the remaining authors.
FUNDING/SUPPORT Funding was provided by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Foundation/Nestle Nutrition Career Development Award and National Institutes of Health (NIH) K23 DK101688 (B. P. Chumpitazi). This study also was supported in part by NIH R01 NR013497 (R. J. Shulman), the US Department of Agriculture/Agricultural Research Service under Cooperative Agreement No. 6250-51000-043 (R. J. Shulman), and NIH P30 DK56338, which funds the Texas Medical Center Digestive Disease Center.
Identification
Copyright
© 2016 by the Academy of Nutrition and Dietetics.
