What is irritable bowel syndrome?

Related links:

• Our services: How we care for children with irritable bowel syndrome

Related tests and treatments:

• Biofeedback
• Cognitive behavior therapy

About irritable bowel syndrome

Irritable bowel syndrome is an intestinal disorder that involves abdominal pain along with constipation, diarrhea or both.

What causes IBS?

Experts aren’t exactly sure, though they know that the abdominal pain associated with IBS stems from an abnormality in how the GI tract and brain interact. The nervous system in the digestive tract that controls digestive activity may be more sensitive in certain children. Therefore, in children with IBS, normal gas, motion and/or rumbles of the intestines can often be perceived as painful. Other factors that could trigger IBS symptoms include:

• Motility abnormalities – There might be a problem with how the muscles contract and propel food through the GI tract.
• Visceral hypersensitivity – The viscera are the organs inside the abdominal cavity. The GI tract is the largest in the abdomen, and research has shown that patients with functional GI disorders have a heightened sensitivity to changes within the intestine, such as the presence of food or distension of the viscera.
• The higher brain – It is well known that a person’s emotional state can directly influence activity in the gastrointestinal tract. High levels of anxiety, stress or anger can induce diarrhea or pain. Stress is not limited to emotional issues: It also includes physical stresses such as a viral illness or another physical disorder.

All of the above factors can trigger symptoms. It is important to stress to the child with a functional bowel disorder that their abdominal pain is real and not imaginary.

How often does IBS occur?

IBS is fairly common, affecting anywhere from 10-15 percent of the population.

How does IBS develop?

This condition can develop at any age. Stress can trigger or worsen IBS symptoms, and IBS symptoms can suddenly appear after a gastrointestinal infection.

What are the symptoms of IBS?

In addition to abdominal pain, symptoms may include:

• Gassiness
• Bloating
• Constipation
• Diarrhea
• Urgent bowel movements
• Sensation of incomplete bowel movements
• Mucus in the stool

Who is at risk of developing IBS?

There is no known gene that causes IBS, but the disorder does seem to occur more often in families where a child or a parent has the disorder. Girls are affected by the disorder slightly more often than boys.

Why is IBS a concern?

Children with this condition often do not feel well. Those who have diarrhea may have little warning of their need to go to the bathroom and thus may be embarrassed and avoid going to school or socializing with friends. Children with IBS can become depressed or anxious because of the stress of the disorder. Although most children with IBS continue to grow and develop normally, some children may eat less to avoid the pain that can accompany digestion and lose weight as a result.

How is IBS diagnosed?

A thorough medical history and physical exam are usually all that’s needed to diagnose IBS. There are no specific tests used to diagnosis IBS, though the doctor may recommend testing to make sure another disorder is not missed, particularly if your child is experiencing other concerning symptoms — such as blood in the stool or poor growth.

What is the treatment for IBS?

Lifestyle changes can be very effective in managing this condition. High-sugar diets can trigger pain with diarrhea, so your child’s doctor might first suggest reducing sugary drinks and other sweets to see if that helps improve your child’s symptoms. If you notice that certain foods seem to set off your child’s symptoms, you should try to avoid those foods. Reducing any stressors in your child’s life can also help.

If your child’s abdominal pain is severe, the doctor might recommend pain medication. Biofeedback and cognitive behavior therapy can also teach your child how to cope with chronic abdominal pain and improve or eliminate symptoms.

What happens after treatment?

If your child’s symptoms continue, then the doctor may suggest another course of treatment.

When should you contact a physician?

Talk to your doctor if your child is experiencing frequent belly pain and diarrhea and/or constipation.

What is the long-term outlook for IBS?

There is no cure for IBS, though a large percentage (50 to 60 percent) of children do experience complete resolution of their symptoms. Thirty-three percent of adults who have IBS can trace their symptoms back to childhood.

How do I live with IBS?

It’s important to identify the stressors surrounding your child and do what you can to reverse them. Instead of concentrating on the pain, try to help your child focus on something fun or pleasant during a painful episode. In many instances, the medical team will work with your child’s school to make sure he/she has the necessary resources to succeed in a stressful environment. The more your child functions, the better the chance of improving symptoms. Missing school should be highly discouraged.