Irritable Bowel Syndrome in Children

Irritable Bowel Syndrome in Children

Irritable bowel syndrome (IBS) is a group of symptoms that affects the organs responsible for digestion (gastrointestinal or GI tract). IBS is not one specific disease.

A child who has IBS may have symptoms from time to time, but the condition does not permanently damage the organs of the body.

To regulate how the GI tract works, the body sends signals back and forth between the intestines and the brain. If your child has IBS, there may be a problem with these signals.

As a result, the GI tract does not function normally. The intestines may become more sensitive and overreact to certain things. This may be especially true when your child eats certain foods or when your child is under stress.

There are four types of IBS. These may be determined based on the consistency of your child’s stool (feces):

  • IBS with diarrhea.
  • IBS with constipation.
  • Mixed IBS.
  • Unsubtyped IBS.

It is important to know which type of IBS your child has. Certain treatments are more likely to be helpful for certain types of IBS.

What are the causes?

The exact cause of IBS is not known.

What increases the risk?

Your child may have a higher risk for IBS if he or she:

  • Has a family history of IBS.
  • Has a mental health condition.
  • Has had food poisoning (bacterial gastroenteritis).

What are the signs or symptoms?

Symptoms of IBS vary from child to child. The main symptom is abdominal pain or discomfort. Other symptoms usually include one or more of the following:

  • Diarrhea, constipation, or both.
  • Abdominal swelling or bloating.
  • Feeling full or sick after eating a small or regular-sized meal.
  • Frequent gas.
  • Mucus in the stool.
  • A feeling of having more stool left after a bowel movement.

Symptoms tend to come and go. They may be triggered by stress, mental health conditions, or certain foods. In some cases, symptoms may come and go randomly.

How is this diagnosed?

This condition may be diagnosed based on a physical exam and your child’s medical history and symptoms. Your child may have tests, such as:

  • Blood tests.
  • Stool test.
  • Ultrasound.
  • Colonoscopy. This is a procedure in which your child’s GI tract is viewed with a long, thin, flexible tube.

How is this treated?

There is no cure for IBS, but treatment can help relieve symptoms. Treatment may include:

  • Changes to your child’s diet, such as having your child:
    • Follow a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet as told by your health care provider. FODMAPs are sugars that are hard for some people to digest.
    • Eat more fiber.
    • Avoid foods that cause symptoms.
    • Drink more water.
    • Eat medium-sized meals at the same times every day.
  • Medicines. These may include:
    • Fiber supplements, if your child has constipation.
    • Medicine to control diarrhea (antidiarrheal medicines).
    • Medicine to help control muscle tightening (spasms) in the GI tract (antispasmodic medicines).
    • Medicines to help with a mental health condition, such as antidepressants or tranquilizers.
  • Talk therapy or counseling.
  • Working with a diet and nutrition specialist (dietitian) to help create a food plan.
  • Taking actions to help your child manage stress.

Follow these instructions at home:

Eating and drinking

  • Have your child:
    • Eat a healthy diet.
    • Eat medium-sized meals at about the same time every day. Do not let your child eat large meals.
    • Gradually eat more fiber-rich foods. These include whole grains, fruits, and vegetables. This may be especially helpful if your child has IBS with constipation.
    • Eat a diet low in FODMAPs. Avoid foods that are high in certain carbohydrates, such as citrus fruits, cabbage, garlic, and onions.
    • Drink enough fluid to keep his or her urine pale yellow.
    • Keep a journal of foods that seem to trigger symptoms.
  • Your child should avoid food and drinks that:
    • Contain added sugar.
    • Make symptoms worse. Dairy products, caffeinated drinks, and carbonated drinks can make symptoms worse for some children.

Medicines

  • Do not give your child aspirin because of the association with Reye syndrome.
  • Give your child over-the-counter and prescription medicines and supplements only as told by his or her health care provider.

General instructions

  • Have your child exercise regularly. Ask your child’s health care provider to recommend good activities and exercises for your child.
  • Help your child practice ways to manage stress. Getting enough sleep and exercise can lower stress. If your child needs help with this, work with his or her health care provider or therapist.
  • Make sure you know how much your child is expected to grow, so that you can watch for signs that your child is not eating enough. Your child’s health care provider can tell you what your child’s general height and weight should be based on your child’s age.
  • Keep all follow-up visits as told by your child’s health care provider and therapist. This is important.

Contact a health care provider if your child:

  • Is not growing as expected.
  • Has bleeding from the rectum.
  • Has pain that does not go away.
  • Has trouble swallowing.
  • Vomits often.
  • Has diarrhea at night.

Get help right away if your child:

  • Has severe pain.
  • Has a fever.
  • Has bloody or black stools.
  • Has severe abdominal bloating.
  • Has unusual sleepiness or drowsiness.
  • Cannot stop vomiting.

Summary

  • Irritable bowel syndrome (IBS) is not one specific disease. It is a group of symptoms that affects digestion.
  • A child who has IBS may have symptoms from time to time, but the condition does not permanently damage the organs of the body.
  • There is no cure for IBS, but treatment can help relieve your child’s symptoms.
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