Irritable Bowel Syndrome (IBS) in Children: Causes And Symptoms

Irritable bowel syndrome or IBS is a disorder affecting the digestive system, especially the large intestine. IBS in children may produce a group of symptoms such as stomach ache, cramps, diarrhea, and constipation. This condition is not extensively studied in children, but existing research indicates that functional defects in intestinal movements are the major cause. If these symptoms that appear to be caused due to food intolerance or a stomach infection persist or keep recurring, you should consult a doctor for a thorough diagnosis. Keep reading this post as we discuss the symptoms, causes, remedies, and treatment for IBS in children.

What Is Irritable Bowel Syndrome?

IBS is a functional gastrointestinal (GI) disorder caused due to the changes in how the GI tract functions. It is classified as a functional disturbance in the absence of proof of a disease.

It is a set of symptoms that occur at the same time. These symptoms can vary from just mild to severe pain that might be intermittent but can sometimes last for many hours.. It is sometimes associated with diarrhea but can also lead to constipation. The symptoms may vary from one person to another, as do the causes of IBS and the treatment options.

Though IBS can affect a person of any age, it is common among teenagers and individuals in their late 20s and 30s (1). The risk of developing IBS is higher if the child:

• Is a female

• Has a history of IBS in the family

• Has psychological problems such as anxiety attacks or panic disorders

• Has experienced a psychological trauma due to sexual abuse, loss of a close relative or friend, accident, etc.

But what causes IBS in children?

Causes Of IBS

There are only a few studies about IBS in kids, so there is little information about how common the condition really is in children. However, the few studies published listed the following as reasons (2):

• Functional issues in the GI motility is one of the most common causes of IBS. This happens when the motility in the colon is either too fast (causing diarrhea), too slow (causing constipation), or erratic. The changes could be associated with hyperactivity in the child or overeating. This leads to spasm of the muscles in the bowel, resulting in abdominal pain.

• Hypersensitivity, including intolerance or allergy to certain foods.

• Gastroenteritis caused by bacteria, mostly Salmonella, can irritate the stomach, and can sometimes lead to an irritable bowel syndrome, which lasts longer.

• Stress and psychological problems such as depression, anxiety, and panic disorder may not cause IBS, but worsen the symptoms (3)

• Usually, the gut contains a few good bacteria living in it but when the amount of intestinal bacteria increases, it is known as small intestinal bacterial overgrowth (SIBO), and leads to IBS. However, there aren’t enough studies to support this theory.

• There is a strong family history of other family members with IBS. However, no specific gene has yet been identified..

Children get stomach or abdominal pain even without IBS. So, how do you know if the pain pertains to this condition or something else?

Symptoms Of IBS In Children

Children with an irritable bowel syndrome may display symptoms that can also indicate other GI tract disorders. However, if the symptoms are intense and persist for a long time, then they could be pointing towards IBS. Common IBS symptoms in children include:

• Pain or discomfort in the abdomen. If the child complains of a stomach ache every day, for two to three weeks, it may be a sign of an irritable bowel

• Change in toilet habits – going to the bathroom more often or less often than usual

• Change in the appearance of the stool as it may be watery or looser than usual, or harder than usual, often resulting in pain when they go to the toilet

• Diarrhea is a common symptom when the colon’s motility is faster than normal. The child may go to the toilet three or four times a day, pass watery stools, and also feel a constant urgency for a bowel movement.

• In some children, this might lead to encopresis (uncontrollable bowel movement resulting in soiling of the pants)

• Constipation: The child has difficulty passing stool every day; frequency of bowel movement may reduce from once or twice a day to once in two to three days. The stool may be dry and hard.

• The presence of mucus in stool..

• Bloating of the abdomen

Some children may also experience nausea and have a poor appetite. However, vomiting is seldom symptom of IBS. (More serious signs like fever, bloody stools, joint pains, or swollen extremities are definitely not the symptoms of irritable bowel syndrome in children).

If the child displays these symptoms at least twice a week, for two months or more, a diagnosis of IBS can be made. Also, if the child tends to get relief from these symptoms after a bowel movement, it points even more to the diagnosis of IBS.

Diagnosing Irritable Bowel Syndrome In Kids

To diagnose IBS in children, the doctor or healthcare professional will start by collecting the child’s medical history. They may also want to know about the family’s medical history to determine if the condition is genetic. The doctor will ask you about recent infections, use of medications, traumatic or stressful events that the child may have had, among others.

They will confirm the diagnosis as IBS if the child has had the symptoms for over two months, although the physical examination and medical history do not show any possible causes.

Additional tests or procedures may be recommended if there is a history of celiac disease, peptic ulcer disease, or inflammatory bowel disease in the family. The tests or procedures prescribed by the doctor may include:

• Blood tests
• Urine test
• Stool test
• X-ray of the abdomen
• Ultrasound of the abdomen
• Colonoscopy or flexible sigmoidoscopy -usually only if there are other signs that the doctor might be concerned about.
• Lactose breath hydrogen test
• Endoscopy

If the doctor suspects the symptoms are because of an underlying medical condition, they may recommend other tests.

Treatment For IBS In Children

IBS is a chronic condition that has no cure. Treatment for IBS is about controlling the symptoms and eliminating the discomfort that the child goes through every day. Usually, the treatment involves using medication to alleviate abdominal pain, relieve gas and bloating, manage constipation and control loose motions or diarrhea.

Change in diet, supplements, and treating the underlying medical condition through alternative therapy are some of the ways to treat IBS. The exact course of treatment, however, is symptom-specific.

1. Treatment through change in diet

The food your child eats has a direct impact on the GI tract. That is why a change in the diet is one of the most effective treatments for IBS. As irritable bowel syndrome is not individualized, the IBS diet (what you eat and do not eat) is more or less the same for all IBS patients.

Avoiding dairy can be a good way to control the symptoms of IBS. Also, including foods containing fiber can help relieve constipation, while adding too much fiber might lead to loose motions.

2. Use of probiotics

Probiotics are living organisms (good bacteria) that are similar to the bacteria residing in the gut. Including a healthy portion of probiotics such as yogurt can help reduce the symptoms of IBS. You can also get probiotics through dietary supplement powders, capsules, and tablets. Talk to your doctor about the right amount of probiotics to include in the diet for the best results.

3. Medications

Dietary changes and use of probiotics can alleviate the symptoms of IBS. But they will not reduce the pain. So, the doctor may prescribe medications for managing diarrhea, constipation, and abdominal pain. Prescription medications for IBS can include:

• Laxatives and fiber supplements to relieve constipation and enable smooth bowel movement.

• Antidiarrheals to prevent loose motions and excessive loss of water from the body.

• Antispasmodics such as pinaverium and cimetropium to provide relief from abdominal pain.
• Antidepressants in small doses to provide relief from symptoms including abdominal pain. Also, these medicines can help in improving moods and sleep patterns, and stabilizing the GI tract’s activity.

4. Therapy

If IBS is caused due to mental health problems, the treatment methods mentioned below can help.

• Psychological therapies such as cognitive behavioral therapy, psychodynamic therapy, and interpersonal therapies can help the child or teenager deal with stress.

• Alternative therapies such as hypnotherapy can help the child relax and deal with stress in a less damaging way. Such treatments help the child relax his colon muscles, thus stabilizing its motility.

Preventing IBS In Kids

The only way to prevent IBS is to know what triggers it. Let’s begin with a list of foods that you must avoid to keep IBS at bay.

• Fatty foods such as fries, or dishes cooked in large amounts of oil, butter, or margarine

• Chips, cookies, and other processed foods

• Bread and cereals made with refined grain or wheat, which contain gluten

• Dairy products, especially cheese

• Protein-rich foods

• Foods with high fructose content including fruits and vegetables such as watermelon, apples, etc.

• Foods such as peas, cauliflower, and sugar-free gum or chocolates that contain polyols

• Carbonated drinks and drinks that contain alcohol, caffeine, and chocolate

In short, you must avoid foods that contain fermentable oligosaccharides, monosaccharides, and polyols, or FODMAP . In addition to avoiding these foods, follow the below tips:

• Give the child small meals – do not let him or her overeat, as that can trigger the symptoms of IBS.

• Avoid eating foods of different temperatures such as hot soups and cold water in the same meal.

• Drink water after the meal or an hour before the meal. Avoid drinking water when you eat.

• Drink plenty of plain (still) water every day.

• Have a set time for meals every day. Make sure that the child eats all meals, as skipping them can trigger the symptoms.

• Yoga involving stretching, breathing, and meditating and can help in alleviating the symptoms of IBS.

A little care can go a long way in keeping the IBS quiet and out of your child’s life. Also, isn’t prevention better than cure?

Home Remedies For IBS

The symptoms of irritable bowel syndrome can be minimized or eliminated with these natural or organic remedies that you can whip up at home.

1. Yogurt, one of the probiotics which contain live bacteria is good for the gut. The bacteria protect the intestinal lining from inflammation and remove bad bacteria from the gut. You can give the kid yogurt as it is or make a smoothie with it.

2. Peppermint oil has a soothing effect on the intestinal muscle, called smooth muscle. You can take this in the form of candy or capsules. However, check with the doctor before you give the child a dose of peppermint oil.

3. Peppermint tea can help in reducing IBS symptoms such as bloating, gas, cramping, diarrhea, and intestinal spasms. Give the child a cup of peppermint green tea three to four times a day.

4. Ginger can help in minimizing the bloating and gassy feeling. Include it in the food, consume it with honey, or make ginger tea and give it to the kid.

5. Fennel seeds help in eliminating the fats from the intestine. Also, fennel seeds can reduce the inflammation and bloating caused due to IBS. Boil fennel seeds in a cup of water, and let it steep for ten minutes before giving it to the child.

6. Flax seeds are rich in good fats – omega 3 fatty acids – that are needed for a healthy immune and digestive system. Ground flax seeds and give to the kid. Or you can add a tablespoon of flax seeds to water and let it sit for three hours. Give that to the child before bed for easy bowel movements.

7. Raw cabbage juice has a mild laxative effect and sulfur that helps in cleansing the mucous membranes of the GI tract. Chop raw cabbage and blend it with some water. Give half a glass of the blend to the child.

8. Bananas can help relieve bloating and gas. However, this is only if the child has diarrhea. Just give the child a small piece of it, as eating the entire fruit can worsen diarrhea.

9. Carrots are a source of pectin that helps in reducing the symptoms of IBS. Raw carrot juice or boiled carrot puree (if raw carrots cause a stomach ache) can be given to treat diarrhea and constipation.

11. Chamomile tea has tannins which relieves symptoms such as diarrhea, abdominal spasms, and intestinal inflammation. You can give your child the herb tea twice a day.
12. Oat bran can supply your child with the fiber he or she needs to reduce symptoms such as constipation. It is nutritious and can be added to breakfast cereals, oatmeal, or even smoothies and salads.

References

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