Irritable bowel syndrome (IBS) is a common intestinal disorder that can cause cramps, gas, bloating, diarrhea, and constipation. It is sometimes called a "nervous stomach" or a "spastic colon." Certain foods can trigger the symptoms of IBS, as can emotional stress, infections, and physical trauma.

Although IBS can be uncomfortable and embarrassing for kids, it doesn't cause serious health problems. Doctors can help kids manage IBS symptoms with medications and changes in diet and lifestyle, so that kids with IBS can lead active, healthy lives.

What Causes IBS?

The specific cause of IBS is unknown, although it tends to run in families. Research has shown that kids with IBS are more sensitive to pain, discomfort, and fullness than kids without IBS. Certain foods — like milk, chocolate, caffeine, greasy foods, fast foods, and spicy foods — also tend to trigger IBS. In some cases, the triggers are never found.

Stress can also play a part in IBS in healthy kids. Some kids with IBS also tend to be particularly sensitive to stress and emotional upsets. Because nerves in the colon are linked to the brain, stress and conflict (things like family problems, moving, taking tests, going on vacation, and trauma) can affect how well the colon functions by speeding up the colon while slowing down the stomach.

What Are the Symptoms of IBS?

Kids with IBS usually have at least two of the following symptoms for at least 3 months over the preceding year:

• pain or discomfort that is relieved after a bowel movement
• pain or discomfort that is accompanied by changes in how often the child has to go to the bathroom
• pain or discomfort that is accompanied by changes in the way the child's stool (poop) normally looks. Some kids get constipated and their stools become hard (and difficult to pass); other kids develop diarrhea.

How Is IBS Diagnosed?

There is no specific test to diagnose IBS. Doctors usually diagnose it by taking the child's full medical history (including any family history of IBS) and by doing a physical exam. Answering questions about things like gas and diarrhea can be embarrassing, so assure your child that the doctor deals with issues like this every day and needs the information to help your child feel better.

The doctor will probably also ask about your child's environment at home and at school, and may suggest that you help your child keep a food diary to determine if certain foods or substances trigger IBS symptoms.

Most of the time, doctors don't need medical tests to diagnose IBS, but sometimes they order blood and stool tests and X-rays to rule out other intestinal problems.

How Is IBS Treated?

There's no cure for IBS. But many things can help reduce your child's IBS symptoms, including:

• Dietary changes. Some kids with IBS find that careful eating helps reduce or eliminate IBS symptoms. You might avoid serving very large meals, drinks with caffeine, spicy or fatty foods, or other foods that seem to trigger the symptoms.
• Lifestyle changes. If the symptoms appear to be related to stress, talk to your child about what you can do to help manage pressures related to school, home, or friends.
• Regular exercise and stress reduction. Exercise can foster good digestion and it's also a great stress release. If your child suffers from anxiety or depression, your doctor might advise a consultation with a child psychologist or another therapist.
• Medications. Doctors sometimes prescribe medications to treat the individual symptoms of IBS, such as laxatives to relieve constipation, anti-diarrhea medications, muscle relaxants, or antidepressants. Talk with your doctor before giving your child any over-the-counter medications for IBS symptoms.
  
  A number of new medicines targeting the neurotransmitter serotonin are now available to treat IBS, but must be used carefully in certain children and adolescents.
• Stress reduction and coping strategies. Hypnosis, breathing exercises for relaxation, and psychotherapy are becoming increasingly popular and safe ways to manage IBS.

Though IBS isn't life threatening, it can affect quality of life. It's important to talk with the doctor about ways to manage IBS symptoms to help your child lead an active and healthy life.

Reviewed by: Devendra Mehta, MD, MBBS, MS, MRCP
Date reviewed: October 2007