An 8-year-old is brought to the emergency department by her mother. She is having intermittent episodes of loose stools and recurrent abdominal pain. The child is diagnosed with irritable bowel syndrome (IBS). Which of the following instructions will help reduce the frequency of symptoms?
• IBS is characterized by chronic abdominal pain, bloating, discomfort, and intermittent episodes of loose stools. IBS accounts for 30% of all referrals to gastroenterologists.
• The cause of IBS is unknown. Recent research has supported inflammation, alterations in normal flora, and psychological stress as risk factors for IBS. Symptom management involves trying multiple dietary changes.
• An increase in fiber is generally recommended, but not all studies agree. Due to its safety and frequent placebo effect, a trial of fiber supplementation should be implemented whether through foods or psyllium fiber supplements.
• Incorrect: Increasing milk products is not recommended. A lactose-free diet should be trialed in patients due to the similarities of symptoms between IBS and lactose intolerance.
• Incorrect: Forcing fluids may cause an excessive GI response, worsening symptoms of IBS.
• Incorrect: IBS may be associated with impaired absorption of some carbohydrates (fructose, fructans, lactose, sorbitol), but not all carbohydrates should be avoided.