Irritable Bowel Syndrome (also known as IBS, spastic colon, and sometimes improperly termed spastic colitis) is a devastating condition that afflicts up to 20% of the world's population, children as well as adults.
Irritable Bowel Syndrome in Children? Can a Child Really Have IBS?
Irritable Bowel Syndrome (IBS) is the most common chronic health disorder in America, Canada, the UK, Australia, and New Zealand, affecting more people than asthma, diabetes, and depression combined. Irritable Bowel Syndrome is a physical - not psychological - disorder that affects mainly the bowel, which is also called the large intestine. The bowel is the part of the digestive system that makes and stores stool.
IBS is characterized by its symptoms: lower abdominal pain or discomfort, diarrhea, constipation (or alternating diarrhea/constipation), gas, bloating, and nausea. There is no cure for Irritable Bowel Syndrome, but there are many very effective ways of controlling and even eliminating IBS symptoms.
IBS can be occur at any age, including childhood, and there is evidence that some people may be born with Irritable Bowel Syndrome.
Irritable Bowel Syndrome is not a disease. It's a functional disorder, which means that the bowel simply does not work as it should. Irritable Bowel Syndrome in children as well as adults is characterized as a brain-gut dysfunction.
Symptoms of Irritable Bowel Syndrome in Children
It's important to verify that a child's symptoms match those of IBS before you accept this diagnosis. As noted, Irritable Bowel Syndrome in children is characterized by its symptoms: continuous or recurrent lower abdominal pain or cramping (from mild to excruciating) in association with altered bowel motility (diarrhea, constipation, or both). Attacks may strike suddenly at any time of day or night, and may occasionally - though not typically - wake a child from a sound sleep.
Gas and bloating are common, but vomiting isn't, though it can occur due to nausea from the pain. Upper GI symptoms are not a typical part of the syndrome. For females past the age of puberty, attacks are often associated with menstruation. Passing blood, running a fever, swollen extremities, and joint pain are not symptoms of IBS, and point to other disorders. IBS is diagnosed in part by the use of the official diagnostic criteria known as the Rome Guidelines.
What Needs to Be Ruled Out For an IBS Diagnosis in Children?
In essence, the diagnosis of IBS in children is a process of exclusion. There is no medical test available that will be positive for IBS; instead, your child's doctor will test for all other illnesses that can mimic IBS symptoms, and if those tests are negative, and if your child's symptoms fit the Rome Guidelines for Diagnosis, your child will then be diagnosed with IBS. In particular, it's important that the following diseases are excluded before you accept a diagnosis of IBS in your child:
Inflammatory bowel diseases (Crohn's and Ulcerative Colitis)
Food allergies, intolerances, and malabsorptions (fructose, lactose, etc.)
Celiac (a genetic, autoimmune disorder resulting in gluten intolerance)
Bacterial infections and small intestine bacterial overgrowth (SIBO)
The following diseases are typically excluded in adults only, as children are normally at minimal to no risk:
Colon and carcinoid cancer
Diverticulosis / Diverticulitis
What Tests Does a Diagnosis of Irritable Bowel Syndrome in Children Require?
As a rule, all possible physical, structural, and infectious abnormalities of the GI tract need to be unquestionably eliminated before you accept an IBS diagnosis in your child. This requires a physical examination, preferably by a board-certified pediatric gastroenterologist, and may include the following studies:
Complete blood count, sedimentation rate, and chemistries
Blood and/or breath tests for gluten, fructose, and lactose intolerances
Breath test for small intestine bacterial overgrowth (SIBO)
Stool for ova, parasites, and blood
Less commonly, children may need the following exams:
Liver function tests
For females, a gynecological exam including CA-125 blood test for ovarian cancer
Other diagnostic studies should be minimal and will depend on the child's symptom subtype. For example, in children with diarrhea-predominant symptoms, a small bowel radiograph or lactose/dextrose H2 breath test may be done. For children with pain as the predominant symptom, a plain abdominal radiograph during an acute episode to exclude bowel obstruction and other abdominal pathology. For children with any numbness in association with constipation, Multiple Sclerosis should be excluded.
In general, the specific medical tests needed to rule out disorders other than IBS will depend upon your child's age, health history, family health background, and specific symptoms. Children often require fewer tests than adults, as many diseases that mimic IBS are rarely, if ever, found in childhood.
Points to Remember about Irritable Bowel Syndrome in Children
* IBS is a functional disorder in which the bowel doesn't work as it should.
* IBS can cause cramping, bloating, gas, diarrhea, and constipation.
* IBS does not damage the bowel.
* IBS cannot be self-diagnosed.
* A doctor should diagnose IBS based on your child's symptoms and the elimination of other possible diseases through various medical tests.
* Stress and foods (particularly fats, insoluble fibers, and GI irritants) can trigger symptoms, but the underlying pathology of IBS in children is caused by a brain-gut dysfunction.
Once your child has a firm IBS diagnosis, take heart. While there is no cure yet, there are many ways to successfully manage - and prevent - all IBS symptoms in children. You and your child can control IBS, not vice versa.
Questions to Ask Your Child's Doctor about Irritable Bowel Syndrome Symptoms
If your child has been given an IBS diagnosis, at the next follow-up appointment with your child's physician take along this list of Questions to Ask Your Child's Doctor About IBS.
Treatments for Irritable Bowel Syndrome in Children
For immediate tangible help controlling all IBS symptoms in children, get The First Year IBS, by author Heather Van Vorous, who has had IBS since age 9. This book has special sections throughout just for children with IBS and their parents.
Once you're confident that your child has been properly diagnosed with IBS, there are several key IBS treatments for successfully managing symptoms: