Current Approaches to Pain Syndrome Management in Children with Irritable Bowel Syndrome

Functional gastrointestinal disorders, particularly irritable bowel syndrome (IBS), are among the most prevalent gastrointestinal conditions in children. Post-infectious IBS develops following acute intestinal infections due to persistent neuroimmune disturbances and is characterized by chronic abdominal pain that significantly impairs patients’ quality of life. The aim of this study was to evaluate the efficacy of different therapeutic regimens for IBS in children aged 4-17 years. This open-label, prospective, randomized, multicenter trial included 106 patients divided into three groups: Group 1 received probiotic monotherapy (Bifidobacterium spp., Lactobacillus rhamnosus); Group 2 received monotherapy with Spascupreel® (a homeopathic spasmolytic agent); and Group 3 received combination therapy (probiotic + Spascupreel®). Treatment efficacy was assessed using validated scales IBS-SSS and SF-36, along with 4- and 5-point clinical rating scales. Statistical analysis was performed using Student’s t-test, Mann-Whitney U test, and Spearman’s rank correlation. Results demonstrated that Spascupreel® monotherapy provided the most rapid symptomatic relief in the short term - significant pain reduction and improved physical functioning were observed as early as week 2. However, the most sustained and comprehensive improvement - including pain reduction, enhanced emotional well-being, increased social activity, and overall quality of life - was achieved with combination therapy. Complete resolution of pain was observed in 53.7% of all patients, with the highest rates in Group 2 (65%) and Group 3 (53.3%, accompanied by greater symptom stability). Combination therapy also led to statistically significant reductions in abdominal bloating (p=0.03) and improved nighttime sleep (p=0.03). These findings support the clinical utility of the bioregulatory agent Spascupreel®, both as monotherapy and in combination with probiotics, for the management of IBS in children. The combined approach demonstrates a synergistic effect, not only alleviating symptoms but also improving long-term outcomes. Results underscore the need for further randomized, placebo-controlled trials with objective assessment methods to standardize treatment protocols for functional gastrointestinal disorders in pediatric practice.

irritable bowel syndrome, post-infectious IBS, children, pain syndrome, probiotics, Spascupreel®, functional gastrointestinal disorders, bioregulatory therapy, Rome IV criteria

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