Irritable Bowel Syndrome in Children

Irritable bowel syndrome (IBS) is a digestive disorder that causes abdominal pain, bloating, gas, diarrhea, and constipation--or some combination of these problems. IBS affects people of all ages, including children.

IBS is classified as a functional disorder because it is caused by a problem in how the intestines, or bowels, work. People with IBS tend to have overly sensitive intestines that have muscle spasms in response to food, gas, and sometimes stress. These spasms may cause pain, diarrhea, and constipation.

In children, IBS tends to be either diarrhea-predominant or pain-predominant. Diarrhea-predominant IBS is most common in children under age 3. The diarrhea is usually painless and alternates with bouts of constipation. These children usually have fewer than five stools a day, and the stools tend to be watery and soft. Pain-predominant IBS mainly affects children over age 5. In the younger children the pain tends to occur around the navel area, and in older children, in the lower left part of the abdomen. The pain is crampy and gets worse with eating and better after passing stool or gas.

In addition to the symptoms described above, children with IBS may also have headache, nausea, or mucus in the stool. Weight loss may occur if a child eats less to try to avoid pain. Some children first develop symptoms after a stressful event, such as teething, a bout with the flu, school problems, or problems at home. Stress does not cause IBS, but it can trigger symptoms.

To diagnose IBS, the doctor will ask questions about symptoms and examine the child to rule out the possibility of more serious problems or diseases. IBS is not a disease--it is a syndrome, or group of symptoms that occur together. It does not damage the intestine, so if the physical exam and other tests show no sign of disease or damage, the doctor may diagnose IBS.

In children, IBS is treated mainly through changes in diet--eating more fiber and less fat to help prevent spasms--and through bowel training to teach the child to empty the bowels at regular, specific times during the day. Medications like laxatives are rarely prescribed because children are more susceptible to addiction than adults. When laxatives are necessary, parents must follow the doctor's instructions carefully. Learning stress management techniques may help some children.

Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, February 2000