Irritable Bowel Syndrome

Key points to remember about irritable bowel syndrome

• irritable bowel syndrome (IBS) is a problem with the way the digestive system works
• it is not the same as inflammatory bowel disease (Crohn's disease and ulcerative colitis)
• IBS can be uncomfortable but causes no damage to the digestive system
• children with IBS can have cramping pain, bloating, diarrhoea and constipation

What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a problem with the way the digestive system works. Children with IBS can have cramping pain, bloating, diarrhoea and constipation. Although IBS can be uncomfortable and embarrassing for children, it doesn't cause serious health problems. Changes in diet and lifestyle can help children manage their IBS symptoms. IBS is not the same as inflammatory bowel disease (Crohn's disease and ulcerative colitis).

What causes irritable bowel syndrome?

​The exact cause of IBS is still not certain but there are some things that may contribute to it.

Children with IBS may be more sensitive to tummy pain, discomfort, and fullness. They can have a digestive system that moves unusually quickly or slowly.

IBS may happen after changes in the balance of the bacteria in the intestine - for example, after an infection, such as gastroenteritis.

Children with IBS may have another family member with IBS.

For some children with IBS, some foods (like milk, chocolate, drinks with caffeine, gassy foods, fatty foods, artificial sweeteners) can make symptoms worse.

Some children with IBS may be more sensitive to stress and anxiety. Because nerves in the colon (also called the large bowel or large intestine) are linked to the brain, stressful events like family problems, moving, school tests, or going on holiday can affect how the colon works.

Sometimes, parents may never find out what triggers their child's IBS symptoms.

What are the signs and symptoms of irritable bowel syndrome?

The most common symptoms of IBS in children are tummy pain (cramping), along with changes in how often children do a poo and whether they have diarrhoea/constipation.

If your child has IBS, they will usually have pain or discomfort together with at least 2 of the following 3 symptoms (at least 3 times a month):

• feeling better after doing a poo
• doing poo more or less often than usual
• having diarrhoea or constipation

Diarrhoea means having loose, watery poo 3 or more times a day and feeling an urgent need to do a poo.

Constipation means doing fewer than 3 poos a week. The poo can be hard, dry and small, making them difficult or painful to push out. Constipation is much more common in children than IBS. See Constipation.

Constipation is much more common in children than IBS. See Constipation.

Other symptoms of IBS may include:

• feeling that a poo is not completely finished
• pooing mucus - a clear liquid made by the digestive system that coats and protects its tissues
• feeling bloated
• doing more farting and burping

How is irritable bowel syndrome diagnosed?

There is no test for IBS. Doctors usually diagnose IBS by checking your child and asking about their symptoms. Answering questions about things like farting and poos can be embarrassing for children. Talk to your child before the appointment and reassure them that the doctor talks about things like this all the time and needs the information to help your child feel better.

Your doctor may ask if anyone in the family has IBS or other digestive system problems. Your doctor may also ask about stress at home and at school.

Your doctor may suggest that you help your child keep a food diary to see if certain foods trigger IBS symptoms.

Most of the time, doctors don't need medical tests to diagnose IBS, but sometimes they may arrange tests to make sure another medical problem is not causing the trouble.

What is the treatment for my child with irritable bowel syndrome?

There's no one solution to get rid of IBS. But many things can help reduce IBS symptoms.

Changes in eating

Some children with IBS find that careful eating helps reduce or get rid of IBS symptoms. Your child might have to avoid milk and dairy products, drinks with caffeine, gassy foods, or other foods that seem to trigger the symptoms. Some children with IBS feel better when they eat smaller, more frequent meals. Your doctor may suggest a special diet called FODMAP. Check information at the Monash University website - about FODMAPs and IBS resources.

Recognising and dealing with stress and anxiety

Talk to your child about worries they may have and what you can do to help manage pressures related to school, home, or friends. You could talk to your child's teacher if there are things that are worrying your child at school.

Talk to your child's doctor if you're worried about their anxiety. If your child has a lot of anxiety or seems depressed, your doctor might arrange for your child to see your local child and adolescent mental health service. Therapy, breathing exercises, or other relaxation techniques can help some children with IBS.

Exercise

Exercise can help digestion. It can also help your child cope better with stress and anxiety.

Sleep

Make sure your child gets enough sleep. See Sleeping sound.

Medicines

If your child has constipation, make sure you talk to your doctor about treatment. See Constipation treatment.

Your child's doctor may prescribe medicines to treat diarrhea, constipation, or cramps. Occasionally, your child may need to see a paediatrician who may recommend treatment for pain. See Chronic or persistent pain. Talk with your child's doctor before giving your child with IBS any over-the-counter medicines for diarrhea, constipation, cramps, or other digestive problems. If your child has constipation, make sure you talk to your doctor about treatment. See Constipation treatment.