Sometimes, your child’s belly pain is just a run-of-the-mill stomachache. But if that pain comes and goes and then comes back again, repeatedly, along with other digestive symptoms, it could be a sign of something more.
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A growing number of kids are developing irritable bowel syndrome, 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, and it’s diagnosed after a medical workup is done and all tests come back negative.
“It’s fairly common, and it comes in different forms,” says pediatric gastroenterologist Sophia Patel, MD.
One study estimates that as many as 6% of middle schoolers and 14% of high schoolers have symptoms indicative of IBS.
For some kids, those symptoms are merely an annoyance. For others, they’re disruptive.
“IBS can affect their 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. Patel says.
The good news is, 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. The other good news is that the range of options is growing.
IBS: A tough nut to crack
Digestive pain can happen at any age, but Dr. Patel 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 patients present earlier or later.
IBS is what’s called a functional disorder (not a disease). This means that 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 is 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, a child will likely need to undergo tests to rule out other potential causes.
Treatment isn’t one-size-fits-all
There’s no cure for IBS, but Dr. Patel says many children are able to improve their symptoms by eating more fiber or 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.
Another thing that can help is behavioral therapy with a psychologist. Through therapy, kids learn skills to manage stress (which can aggravate their symptoms) and cope with their pain.
If lifestyle changes alone aren’t enough to help children control their symptoms, a doctor may prescribe anti-spasmodic medication or acid reducers, in addition to other medications. Some patients also find probiotics to be helpful, Dr. Patel says, but she cautions that studies haven’t consistently shown that they are effective.
IB-Stim: A new treatment option
In the future, doctors may also be able to prescribe a device called IB-Stim that was recently approved by the U.S. Food and Drug Administration for treatment of chronic abdominal pain in kids age 11 through 18.
It’s a small, battery-powered device that’s worn around the ear. It delivers electrical pulses to nerves in the ear that are associated with processing pain.
This kind of nerve stimulation has long been used for other kinds of pain, but this is the first time a device has been approved specifically for IBS.
The device needs to be replaced every five days, but kids can continue to use and replace it for up to three consecutive weeks to help with the pain.
In a study that tested the device against a sham device in 50 patients, 52% of those who got the device reported a 30% or more decrease in their usual pain after three weeks of treatment.
“It looks like the data is promising, but it needs to be investigated further,” says Dr. Patel, who was not involved in the study. “If it’s noninvasive and is not going to cause any serious side effects, it could be worth trying, but whether it works probably depends on the patient.”
Tips for parents
If your child has recurring stomach pain, Dr. Patel recommends making sure they have a complete workup by a pediatric gastroenterologist to make sure there are no 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.”