Irritable Bowel Syndrome

______________________________________________________________________

KEY POINTS

• Irritable bowel syndrome (IBS) is a long-term disorder in which your child’s large intestine (colon) does not always work normally.
• There is no cure for IBS. It is not a life-threatening or dangerous disorder. However, changing food and drink choices and helping your child manage stress usually help relieve the symptoms. Some medicines may also help.
• Follow the full course of treatment prescribed by your child’s healthcare provider. Contact your child’s healthcare provider if your child has new or worsening symptoms.

________________________________________________________________________

What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a long-term disorder in which the large intestine (colon) does not always work normally. The large intestine is also called the large bowel. Although IBS can cause much distress, it does not damage the intestines. It is not a life-threatening or dangerous disorder.

IBS is different from inflammatory bowel disease (IBD). IBD includes ulcerative colitis and Crohn’s disease, which cause swelling, redness, sores, or holes in the wall of the intestine.

Your child may have flare-ups of symptoms throughout life. Although a cure hasn't been found yet, the disorder can usually be controlled.

What is the cause?

The exact cause of IBS is not known. It may be related to changes in the way nerves and muscles in the intestines work together. For example, the nerves in your child’s intestines sometimes may make the muscles squeeze too much when your child eats. This can make food move too fast through the intestines, causing gas, bloating, cramping, and diarrhea. Other times, the muscles may not squeeze enough, which slows the passage of food and causes cramps and constipation.

Your child may be at greater risk for IBS if someone in your family has the disorder. Some foods may trigger attacks. Other possible triggers of attacks are hormonal changes, stress, and an illness such as stomach flu. Other risk factors are depression, anxiety, personality disorder, and a history of childhood sexual abuse.

What are the symptoms?

Although the symptoms of IBS are different from person to person, you may find that your child's symptoms follow a predictable pattern. The most common symptoms include:

• Cramping and pain in the belly that comes and goes. The pain may be mild or severe. It often starts after eating a meal or when your child is under stress, such as if having problems at school, and gets better after having a bowel movement.
• Constipation, diarrhea, or both. Your child may have constipation one week and diarrhea the next. There may be a lot of mucus in your child's bowel movements.

Children who often have diarrhea may not want to go to school or be around other children. Children with IBS can become depressed or anxious.

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. There is no specific test for IBS. The diagnosis is usually based on the symptoms. Your child may have tests or scans to check for other possible causes of symptoms.

To find foods that may be causing symptoms, your child’s healthcare provider may tell you to record:

• All the foods that your child eats
• How much (serving sizes) your child eats of each food
• The times of day when your child eats
• Any symptoms your child has after eating a food
• When the symptoms started and how long they lasted

If your child’s symptoms are not severe, your child’s provider may suggest that you try to find which foods cause symptoms by not letting your child eat certain foods for a while. For example, your child might stop eating milk and dairy products or wheat products for a time. Then you can carefully try adding these foods again, one at a time, to see if your child’s symptoms come back. Ask your child’s provider which foods your child should avoid at first.

How is it treated?

There is no cure for IBS. However, changing food and drink choices and managing stress usually helps relieve the symptoms. Sometimes, medicines may also help.

• Food and drink choices

  Ask your child’s provider about the benefits of talking to a dietitian to learn what your child needs in a healthy meal plan. Talk to your child’s healthcare provider about whether your child should eat more or less high-fiber food. Your child can try eating smaller meals more often each day rather than just 2 or 3 larger meals. Your child may need to avoid certain foods such as those high in fat, some milk products, drinks with alcohol, caffeine, artificial sweeteners, beans, cabbage, cauliflower, broccoli, and raw fruit. Other foods that may cause symptoms include:

  • Chocolate
  • Caffeine in soft drinks, energy drinks, chocolate, coffee, tea, and other drinks
  • Foods with wheat, barley, or rye
  • Sugar-free sweeteners such as sorbitol and mannitol
• Stress

  Help your child identify things that cause stress and suggest ways to help control them. Talk therapy, relaxation, or biofeedback techniques may help your child manage stress. Talk with your child's teacher about ways the school can help.

• Medicines

  Examples of medicines your provider may prescribe are:

  • Bulk-forming agents such as bran or methylcellulose
  • Antispasmodic drugs to slow the amount of muscle squeezing in the intestines and help with diarrhea and pain
  • Antidepressants, which can help control chronic pain
  • Medicines to help with constipation or diarrhea
  • Probiotic medicine to help with good bacteria in the intestines

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. Ask the healthcare provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.

• Help your child learn to manage stress. Teach children and teens to practice deep breathing or other relaxation techniques when feeling stressed. Help your child find ways to relax. For example, talk to family and friends, take up a hobby, listen to music, watch movies, or take walks.
• Your child should stay physically active as advised by your child’s provider. Physical activity helps keep bowel movements regular. It may also help lessen depression and stress.
• Help your child get enough sleep.
• Make sure your child drinks enough liquids to keep the urine clear to light yellow in color.
• Contact your healthcare provider if your child has new or worsening symptoms.