About irritable bowel syndrome in children

What is irritable bowel syndrome in children?

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome is a functional gastrointestinal (GI) disorder, meaning it is a problem caused by changes in how the GI tract works. Children with a functional GI disorder have frequent symptoms, but the GI tract does not become damaged. IBS is not a disease; it is a group of symptoms that occur together. The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with diarrhea, constipation, or both. In the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. The name was changed to reflect the understanding that the disorder has both physical and mental causes and is not a product of a person's imagination.

IBS is diagnosed when a child who is growing as expected has abdominal pain or discomfort once per week for at least 2 months without other disease or injury that could explain the pain. The pain or discomfort of IBS may occur with a change in stool frequency or consistency or may be relieved by a bowel movement.

What is the GI tract?

The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestine - which includes the appendix, cecum, colon, and - rectum - and anus. The intestines are sometimes called the bowel. The last part of the GI tract - called the lower GI tract - consists of the large intestine and anus.

The large intestine absorbs water and any remaining nutrients from partially digested food passed from the small intestine. The large intestine then changes waste from liquid to a solid matter called stool. Stool passes from the colon to the rectum. The rectum is located between the last part of the colon - called the sigmoid colon - and the anus. The rectum stores stool prior to a bowel movement. During a bowel movement, stool moves from the rectum to the anus, the opening through which stool leaves the body.



What are the symptoms for irritable bowel syndrome 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:

How these symptoms occur may vary.

Sometimes mental triggers can bring about IBS symptoms. These mental triggers may also appear as:

  • anxiety
  • depression
  • Fatigue
  • 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 are the causes for irritable bowel syndrome 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.

Read more: What are the causes and risks of IBS? »



What are the treatments for irritable bowel syndrome in children?

Though there is no cure for IBS, the symptoms can be treated with a combination of the following:

  • changes in eating, diet, and nutrition
  • medications
  • probiotics
  • therapies for mental health problems

Eating, diet, and nutrition

Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables may help.

Certain foods and drinks may cause IBS symptoms in some children, such as

  • foods high in fat
  • milk products
  • drinks with caffeine
  • drinks with large amounts of artificial sweeteners, which are substances used in place of sugar
  • foods that may cause gas, such as beans and cabbage

Children with IBS may want to limit or avoid these foods. Keeping a food diary is a good way to track which foods cause symptoms so they can be excluded from or reduced in the diet.

Dietary fiber may lessen constipation in children with IBS, but it may not help with lowering pain. Fiber helps keep stool soft so it moves smoothly through the colon. The Academy of Nutrition and Dietetics recommends children consume "age plus 5" grams of fiber daily. A 7-year-old child, for example, should get "7 plus 5," or 12 grams, of fiber a day.³ Fiber may cause gas and trigger symptoms in some children with IBS. Increasing fiber intake by 2 to 3 grams per day may help reduce the risk of increased gas and bloating.

Medications

The health care provider will select medications based on the child's symptoms. Caregivers should not give children any medications unless told to do so by a health care provider.

  • Fiber supplements. Fiber supplements may be recommended to relieve constipation when increasing dietary fiber is ineffective.
  • Laxatives. Constipation can be treated with laxative medications. Laxatives work in different ways, and a health care provider can provide information about which type is best. Caregivers should not give children laxatives unless told to do so by a health care provider.
  • Antidiarrheals. Loperamide has been found to reduce diarrhea in children with IBS, though it does not reduce pain, bloating, or other symptoms. Loperamide reduces stool frequency and improves stool consistency by slowing the movement of stool through the colon. Medications to treat diarrhea in adults can be dangerous for infants and children and should only be given if told to do so by a health care provider.
  • Antispasmodics. Antispasmodics, such as hyoscine, cimetropium, and pinaverium, help to control colon muscle spasms and reduce abdominal pain.
  • Antidepressants. Tricyclic antidepressants and selective serotonin reuptake inhibitors in low doses can help relieve IBS symptoms including abdominal pain. These medications are thought to reduce the perception of pain, improve mood and sleep patterns, and adjust the activity of the GI tract.



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