Kids and Teens Deal With IBS, Too

Sometimes, your child’s belly pain is just a run-of-the-mill stomachache. But if that pain comes, goes and then comes back again, repeatedly, along with other digestive symptoms, it could be a sign of something more. Pediatric gastroenterologist Jessica Barry, MD, explains.

Can children and teens have IBS?

Irritable bowel syndrome (IBS) is a gastrointestinal disorder that causes pain or discomfort, bloating, gas and diarrhea, or constipation. It’s a form of oversensitivity of the stomach or gut that can trigger symptoms but, unlike inflammatory bowel disease (IBD), it doesn’t damage the gastrointestinal tract.

There are three main types of irritable bowel syndrome: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D) and IBS with mixed bowel habits (IBS-M).

It’s a common condition in adults. Experts estimate that 10% to 15% of the adult population lives with IBS, with only 5% to 7% ever pursuing a formal diagnosis.

But is pediatric IBS a thing?

It is a thing. And it’s become increasingly common over the past two decades. A 2018 U.S. study found that 5% of children ages 4 to 18 years old have IBS. Some population studies in other countries put that number far higher.

For some kids, those symptoms are merely an annoyance. For others, they’re disruptive.

“IBS can affect a child’s quality of life, their day-to-day functioning and whether they’re able to attend school, play sports and hang out with their friends,” Dr. Barry says.

The good news: Most children with IBS continue to grow and develop normally and can find at least some relief with the range of treatment options that are currently available. And there’s more good news: The range of treatment and management options is growing.

Signs and symptoms of IBS in kids

Digestive pain can happen at any age, but Dr. Barry says she sees IBS diagnosed in kids frequently starting around age 7 or 8. That’s typically the point when they’re able to clearly describe what they’re feeling, but some present earlier or later.

What exactly are they feeling? Common symptoms include:

• Abdominal pain, bloating or cramping, especially before, during or after pooping.
• Excessive gas, as in farting more than 25 times a day.
• A strong sense of urgency to get to the bathroom (and, potentially, accidents).
• Chronic constipation, chronic diarrhea or a combination of the two. For example, they may feel an urgent need to go, as if they have diarrhea, but feel too constipated to actually pass anything.
• Feeling like their bowels haven’t completely emptied after going to the bathroom.
• Sweating, dizziness, vertigo, rapid heartbeat and other symptoms of fainting.
• Fatigue and exhaustion, especially after using the restroom.

Anxiety and depression are also important to note because those conditions can both cause and exacerbate irritable bowel syndrome.

Diagnosing IBS in children

IBS is what’s called a “functional disorder.” It’s not a disease. That means the bowels aren’t working properly, but there isn’t any noticeable damage to them like there would be in a person with, say, Crohn’s disease or ulcerative colitis.

This makes it hard to diagnose. There’s no single irritable bowel syndrome test, so a diagnosis is based on a patient’s history and symptoms. And because general digestive symptoms could point to a number of different conditions, your child will probably need to undergo lab and imaging tests to rule out other potential causes.

One way you can help is by working with your child to create a symptom journal. If possible, have them track the following:

• What they eat and when.
• Poop quality (using the Bristol Stool Form Scale).
• Time, duration and intensity of symptoms.
• Pain level.
• Stress or anxiety level.
• Sleep quality.
• Their period (if they have one).

If you have IBS, make a point of sharing that with your kiddo’s provider, too. While we’re still learning about the genetics of the condition, research does suggest having a family member with the condition raises your child’s risk of developing the disorder.

Helping your child manage their IBS

So, your little one’s been diagnosed with IBS. Now what?

There’s no cure for IBS — and there’s no single treatment that works for everybody. But don’t despair! There are lots of different approaches to managing this condition. It’s just a question of mixing, matching and patience.

Treatment and management options

Dr. Barry shares that many children can improve their symptoms by eating more fiber, following a diet that’s low in FODMAPs and avoiding “trigger foods.”

“If we can pinpoint triggers, we might be able to improve their symptoms without even trying medications,” she explains.

Diet isn’t the only thing that can cause an IBS episode. Stress is an equally powerful trigger. She adds that undergoing behavioral therapy with a psychologist can be really helpful. The gut and the brain are deeply connected. Through therapy, kids learn to manage stress, cultivate mindfulness and cope with their pain.

If lifestyle changes alone aren’t enough to help children manage their symptoms, a healthcare provider may prescribe anti-spasmodic medication or acid reducers, in addition to other medications. Some patients also find probiotics to be helpful, Dr. Barry notes, but she cautions that studies haven’t consistently shown that they’re effective.

Your provider is your partner

If your child has recurring stomach pain, Dr. Barry recommends they have a complete workup by a pediatric gastroenterologist to make sure there aren’t any red flags that point to a more serious problem.

She also recommends maintaining a good, active relationship with a gastroenterologist.

“Having that relationship will help you stay up to date on some of these new therapies and recommendations from our national societies,” she says, “and it’s good to be certain that everyone is on the same page.”