Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common disorder that affects people of all ages, including children. It’s classified as a functional disorder, which means there is no identifiable disease of the intestines, bowel or colon. However, the symptoms are real and can cause some children to avoid social events or stay home from school. Most people with IBS, however, are able to control their symptoms through diet, stress management, and sometimes with medications prescribed by their physicians.
IBS in children ranges from mild to severe. While symptoms can be uncomfortable or even disabling, IBS does not lead to other, more serious diseases, such as cancer, celiac disease or inflammatory bowel disease
Symptoms
While the underlying cause of IBS isn’t known, the symptoms may come from muscle spasms in the colon. These muscles normally move food waste through the colon toward the rectum. In children with IBS, painful spasms in these muscles can be triggered by stress, distention from gas, certain foods or simply eating. Symptoms may also come from nerves in the gastrointestinal tract that may have increased sensitivity or increased signaling.
Doctors suspect IBS when kids have the following symptoms at least once a week for two months or more:
Crampy abdominal pain that improves with a bowel movement
Altered stool appearance – constipation or diarrhea
Altered stool frequency – either more or less frequent
Gas or bloating
Mucus with a bowel movement
Certain foods may be more likely to cause spasms. These foods include:
Chocolate
Drinks with caffeine
Carbonated drinks
Gassy foods such as beans
Fried foods
Fatty foods such as milk, cheese and some meats.
Diagnosis
If your child has symptoms of IBS, your doctor will want to rule out other, more serious conditions. At Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition, your specialist will ask about the details of your child’s symptoms, including when they began and how often they occur. Since IBS can run in families, they will also ask whether any close relative has had similar symptoms. They may also ask for a stool sample, which can show if there is any bleeding in the colon.
More tests are usually not needed. However, if your child isn’t growing as expected or has other signs of a more serious condition, your team may suggest tests such as:
Flexible sigmoidoscopy. During this test, the doctor threads a thin, flexible tube with a tiny camera through your child’s rectum to inspect the rectum and lower colon. Your child will be sedated during this test.
Colonoscopy. This is similar to a flexible sigmoidoscopy test, except that the rectum and the entire colon can be viewed. Your child will be sedated during this test.
Imaging tests. CT scans, ultrasound or X-rays may be used to examine the digestive tract.
Lactose intolerance test. Lactose intolerance can cause symptoms that are similar to those of IBS. This can be a simple breath test, or your doctor may ask your child to avoid dairy products for one or two weeks to see if symptoms improve.
Treatments
IBS can’t be cured, but a combination of treatments can help reduce symptoms. Since foods are the main triggers, keep a food diary to help track which foods cause problems. Then follow these steps:
Eliminate problem foods. Share the food diary with your child’s doctor. Together with our registered pediatric dietitians, they can help you design a diet that will minimize IBS symptoms while providing proper nutrition.
Avoid large meals. Smaller, more frequent meals can help your child avoid cramping and diarrhea.
Add dietary fiber. Fiber can help relieve constipation by keeping the stools soft. Ask your child’s doctor how much fiber is appropriate, since too much can cause gas and bloating.
Use medication. Your child’s doctor may recommend a medication such as a laxative, antidiarrheal or an antispasmodic, which can help control painful muscle spasms in the colon. Antidepressant medicines may be use for some children to reduce symptoms. If so, they are used with great care to avoid dependency.
Encourage exercise. Help your child be physically active, since exercise can help digestion. It’s also a great stress reliever.
Consider counseling. If your child seems anxious or stressed, your doctor may recommend a therapist who can suggest relaxation techniques and coping strategies.
Next Steps
Your team at Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition includes full-time experienced and registered pediatric dieticians. These experts get to know your child and can give you individualized advice on a healthy, balanced diet that can minimize your child’s symptoms.
Our dietitians work as a team with our psychologists, pediatricians and others to give your child and your family the highest level of care. We’re dedicated to keeping your child as healthy and happy as possible.
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