5 quick questions about IBS with a pediatric nurse practitioner
Seeing your child struggling with stomach symptoms is no fun. Irritable bowel syndrome could be one potential cause, but how can you know for sure? And what happens next?
Heather Agnew, CPNP from our CHoR gastroenterology and nutrition team explains what irritable bowel syndrome is and how to help
What is irritable bowel syndrome?
Irritable bowel syndrome, or IBS, is a gastrointestinal disorder that can cause a combination of:
- abdominal pain
- bloating
- constipation
- cramping
- diarrhea
- gas
It’s more than simply a one-time tummy ache, though. With IBS, symptoms are recurrent and sometimes severe enough to impact quality of life, causing disruptions in school and other day-to-day activities that kids should be able to enjoy.
How common is IBS in kids?
It’s not very common in young children, which could be partly because their digestive systems and gut-brain communication are still developing, but we begin to see it more as kids enter the school age and teen years. Diagnosis also depends on them being able to accurately describe what they’re feeling, which becomes more understandable around age 7 or so.
When should I bring my child to the doctor for concerns of IBS?
If they’re complaining of constant or recurring stomach pain, it’s worth bringing up to their pediatrician. Other symptoms that would warrant being assessed include changes in bowel movements (constipation or diarrhea) that last for a week or more, bloody bowel movements or pain before/during bowel movements. The pediatrician may recommend seeing a healthcare provider who specializes in gastrointestinal conditions and treatment.
How is IBS diagnosed?
IBS is what we call a functional disorder, which means the bowels aren’t working the way they should but there isn’t damage in the gastrointestinal tract. This makes it a little difficult to diagnose, especially since similar symptoms can be present with a number of different conditions.
There are a few things we can do to determine what’s going on and how to help. A history and physical exam are usually the first steps. That’s where we’ll ask about all the symptoms they’ve been experiencing and for how long, if anyone else in the family has the condition, etc. Then, we may do some lab and imaging tests to determine if the symptoms are caused by something other than IBS.
How do you treat IBS?
Just like there isn’t one test for the condition, there isn’t a treatment or single approach to managing it that works for everyone. It’s often helpful to keep a journal of what your child has eaten, along with the duration and severity of symptoms. If we can pinpoint what’s causing symptoms, we can recommend diet modifications to avoid trigger foods.
The specific triggers are unique to each person, but common culprits include:
- artificial sweeteners
- carbonated beverages
- cruciferous vegetables (broccoli, Brussels sprouts, cabbage and leafy greens)
- fatty foods
- milk products
- sugar
Increasing fiber and decreasing processed foods is another good rule of thumb. A dietitian can help make sure your child is getting the nutrition they need while navigating this process.
IBS can understandably cause stress, which can also lead to symptom flare-ups, so coping strategies to manage that stress are another important component of care. This may include mindfulness and relaxation techniques, regular physical activity, mental health care, consistent sleep schedules and support for managing school-related stressors.
When symptoms are severe despite diet changes and stress management, we may prescribe medications to relieve constipation, diarrhea or pain.