Irritable Bowel Syndrome and Your Child

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WHAT IS IRRITABLE BOWEL SYNDROME?

It's a complex digestive disorder that causes symptoms such as:

• abdominal pain, bloating or swelling
• gas
• irregular bowel habits, including diarrhea, constipation or both
• changes in stool appearance or mucus in the stool
• a need to strain or a sense of urgency when having a bowel movement
• nausea.

While everyone experiences most of these symptoms at one time or another, children with IBS often experience them more frequently and severely. Generally, a child will have symptoms for at least two or three months before a diagnosis of IBS is considered. Because symptoms of IBS may resemble other medical conditions, it's important to talk with your child's physician to ensure an appropriate diagnosis.

HOW COMMON IS IT?

IBS is common in people of all ages, including adults and children. In fact, about 6 percent of middle school students and 14 percent of high school students report IBS symptoms.

WHAT CAUSES IBS, AND IS THERE A CURE?

We're not sure what causes IBS, though some researchers believe it might have something to do with the nerves that lead from the brain to the bowel. In people with IBS, the signals that travel from the bowel to the brain may be sending abnormal pain messages, even though nothing is wrong with the structure of the bowel. Studies in twins also suggest that a person's genes might predispose one to developing IBS.

While there is no cure for IBS, its symptoms can be successfully managed and treated with changes in diet, medication and stress management.

HOW DO I KNOW IF MY CHILD HAS IBS?

There is no test for diagnosing IBS. Instead, a diagnosis is made by your physician after he or she evaluates your child's symptoms and rules out other potential disorders or medical conditions. Your physician may ask you:

• How often does your child's stomach hurt - for example, every couple of weeks, once a week or every day?
• What makes the stomach pain go away? For example, does it go away after your child has a bowel movement?
• How often does your child have a bowel movement - and what is the appearance of the stool?

HOW IS IBS TREATED?

Your child's treatment plan will depend on the symptoms present, their severity and your child's response to treatment. The goal of treatment is to relieve symptoms. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), treating the symptoms of IBS generally includes changes in diet, medication and stress management.

• Dietary changes: Eat foods high in fiber - including fruits, vegetables and whole-grain breads and cereals - to relieve constipation and improve bowel movement regularity. Also, cut out foods that may trigger symptoms, including caffeine and high-fat or spicy foods.
• Medication: Usually, medication is not necessary. Your physician may recommend fiber supplements, laxatives for constipation, or anti-cramping medicines. Occasionally, your doctor may suggest other medicines such as low-dose antidepressants, which help reduce the intensity of pain signals going from the bowel to the brain.
• Stress management: Kids with IBS often feel stress and anxiety, which can trigger symptoms. Learning how to cope with stress will help the symptoms become less severe. Counseling, including behavior therapy and hypnosis, may help your child cope. It's strongly recommended that children with IBS attend school daily, since missing school typically increases stress.

"Irritable Bowel Syndrome (IBS) in Children," National Digestive Diseases Information Clearinghouse NIH Publication No. 09-4640 (November 2008); www.digestive.niddk.nih.gov