What is IBS?
Irritable bowel syndrome (IBS) causes nerves in the gastrointestinal (GI) tract to overreact. This leads to abdominal pain or discomfort as well as frequent diarrhea or constipation. IBS is a group of symptoms, not a disease.
There’s limited data on IBS diagnosis and children, but an older study of North American children in the Journal of Pediatrics found that 14 percent of high school students and 6 percent of middle school students have IBS.
What are the symptoms of IBS in children?
A child is considered to have IBS when they have abdominal symptoms once a week for two months that relate to bowel movements. These bowel movements often:
- occur infrequently or very frequently
- have looser or watery stool or harder, lumpier stool
- help improve IBS symptoms
Children are often less descriptive about their symptoms. You may want to also look for these signs or symptoms (in addition to abdominal pain) after they eat certain foods or have bowel movements:
- appetite loss
- constipation alternating with diarrhea
- cramping and spasm-like pain in the lower stomach
- feeling as if they aren’t passing a full bowel movement
- passing mucus in the stool
- rectal pain
How these symptoms occur may vary.
Sometimes mental triggers can bring about IBS symptoms. These mental triggers may also appear as:
- trouble concentrating
How often should your child have bowel movements?
Young children do tend to pass stools more often than adults. There aren’t definitive numbers, but according to the British Medical Journal, a child that is 3 or 4 years old will tend to pass a stool anywhere from 3 to 4 times a week or 3 to 4 times per day. Passing a painful or difficult stool two times a week or less is considered constipation. As a child ages, they’re likely to have at least one bowel movement a day.
What causes IBS in children?
The causes of IBS in children can be similar to causes in adults. And since IBS isn’t a single disease, it's likely to be due to a number of causes.
Possible causes include:
- dysfunction with nerve communication between the brain and the gut
- mental health conditions like anxiety
- overgrowth of bacteria in the small intestine
- problems with GI motility (contraction of GI muscles)
- bacterial gastroenteritis
If you have a family history of IBS, this can also increase your child’s risk for IBS. While the condition affects the GI tract, it doesn’t damage it. Although there’s no cure for IBS, there are many treatments and at-home care parents can do to help their child with IBS.
How do you treat IBS in children?
Treatments for IBS often depend on the underlying cause if your child’s doctor has identified one. Here are some of the recommendations their doctor may have:
Probiotics: Talk to your child’s doctor to determine the recommended dosage regarding probiotics. Probiotics are dietary supplements that have the same live bacteria found in the GI tract. Taking probiotics in capsule, powder, or tablet form may reduce the symptoms of IBS in some children. You’ll also find them commonly added to foods like yogurt.
Peppermint oil: Researchers found that taking enteric-coated peppermint oil was an effective and safe way to treat IBS in the short term. However, side effects like heartburn were common. A medical literature review from 2005 found that taking 180 to 200 mg of enteric-coated peppermint oil was an effective dosage in treating IBS.
Tips to try
- increase the amount of probiotics in diet
- promote healthy bowel movements with hydration and exercise
- get physically active to relieve stress and anxiety triggers
- ask your doctor for recommended dietary changes based on your child’s symptoms
Fiber and dietary changes
Talk to your doctor before making any significant dietary changes. Everyone’s body is different and only their doctor can make recommendations on dietary changes based on the cause of IBS.
Fiber: Evaluate if your child is getting enough fiber intake every day. This may help reduce constipation.
Take your child’s age in years and add five. This should equal the grams of fiber they should be eating in a day. Introducing fiber sources like whole grains, oatmeal, and fruits in 2 to 3g increments can help.
No matter what diet your doctor recommends, it may help to switch to smaller meals and foods that contain carbohydrates from whole grains, fruits, and vegetables.
Avoid eating or drinking
- caffeinated beverages
- dairy products if they make symptoms worse
- foods like beans and cabbage if they cause your child to have gas
- foods with a lot of caffeine added
- high-fat foods like processed or fast foods
Your doctor may prescribe medications depending on your child’s key symptoms. Examples of these medications may include:
- antidepressants, as they may reduce GI tract activity in low dosages
- antidiarrheal medications like loperamide (Lomotil)
- antispasmodics like hyoscine and cimetropium to reduce cramping
- fiber supplements
- stool softeners or laxatives (to be used sparingly)
Mental health support
Having your child talk to a therapist about their IBS symptoms may help reduce their symptoms. A therapist can explain how emotions may trigger their IBS symptoms and teach them relaxation and management skills to avoid triggering IBS symptoms.
How is IBS diagnosed?
To determine the best treatment for your child’s IBS, their doctor will need to learn more about their symptoms and make sure it’s not related to another GI disease like ulcerative colitis or Crohn’s disease.
During the appointment, their doctor will ask them questions about their symptoms to help differentiate the condition. These include questions about what makes the symptoms worse (or when they get worse) and what makes them better.
To receive a diagnosis of IBS, a child must have experienced abdominal pain and diarrhea or constipation at least once a week for two months.
Tests to help the diagnosis
Sometimes a doctor may recommend testing to rule out GI diseases. The diagnostic tests often depend upon what symptoms a child is experiencing.
Examples of these tests include:
- stool samples to identify if blood is present in the stool (IBS shouldn’t cause blood in the stool)
- colonoscopy or sigmoidoscopy to see the bowel and determine if there’s any damage to the intestinal lining (IBS shouldn’t cause intestinal damage)
- ultrasound to see the intestines and determine if their movement is irregular
Takeaways for IBS in children
It’s important for parents to remember that IBS is a set of symptoms and not a disease that’ll affect a child’s GI health long-term. While there’s no cure for IBS, there are many methods to help your child manage their symptoms and maintain a healthy lifestyle.
You may need to try a few different treatments before finding the combination that’s most effective for your child. During this time, it’s important to ask your child how they’re feeling and follow up on any concerns with their doctor in case they need to adjust your child’s treatment plan.
To learn more about IBS, visit our topic center here.