Irritable bowel syndrome (IBS) in children can cause diarrhea, constipation, and abdominal pain. Treatment may include dietary changes, probiotics, therapy, and medication.
Irritable bowel syndrome (IBS) in children, formerly called spastic or nervous colon, is a functional gastrointestinal (GI) disorder. This results from issues in how the gut and the brain work together.
Children with IBS may have abdominal pain and discomfort and changes in bowel movements. Eating certain types of foods may worsen symptoms.
IBS refers to a group of digestive symptoms that occur without visible damage to the digestive system.
A child may have IBS if they have abdominal pain
- pain that gets better or worse after bowel movements
- changes in how often they have a bowel movement, whether infrequently or very frequently
- change in what their stools look like, from loose or watery stool to harder, lumpier stool
Children are often less descriptive about their symptoms. You may also want to look for these symptoms (in addition to abdominal pain) after they eat certain foods or have bowel movements:
- appetite loss
- backache
- gas or bloating
- constipation alternating with diarrhea
- cramping and spasm-like pain in the lower stomach
- feeling as if they aren’t having a full bowel movement
- headaches
- nausea
- passing mucus in the stool
- rectal pain
How these symptoms occur may vary.
Sometimes, mental triggers can trigger IBS symptoms in people who have it. These mental triggers may also appear as:
- anxiety
- depression
- stress
How often should a child have bowel movements?
Young children tend to pass stools more often than adults.
Children 4 and under typically pass between 1 to 2 stools daily or between 6 and 16 times per week, according to 2023 research.
Children 5 and older may pass stool daily or every other day.
Regularly passing painful or difficult stools or passing stool
The causes of IBS in children can be similar to causes in adults. And since IBS isn’t a disease but rather a collection of symptoms, it’s likely to be due to several causes.
Possible causes or contributing factors of IBS include:
- dysfunction with nerve communication between the brain and the gut
- mental health conditions like anxiety
- overgrowth of bacteria in the small intestine
- problems with GI motility (contraction of GI muscles)
- bacterial gastroenteritis
If you have a family history of IBS, this can also increase your child’s risk for IBS. While the condition affects the GI tract, it doesn’t damage it. Although there’s no cure for IBS, there are many treatments and at-home care parents can do to help their child with IBS.
Treatments for IBS often depend on the underlying triggers, if your child’s doctor has identified one.
Treatment may include:
Dietary changes
Talk with your child’s pediatrician before making any significant dietary changes. Everyone’s body is different, and only their doctor can recommend dietary changes based on the cause and type of IBS. This can include:
- Increasing fiber: If your child has constipation, they may recommend increasing their fiber intake. It’s best to slowly increase a child’s fiber intake, as too much fiber at once can lead to discomfort. You can try adding high fiber foods to their eating plan.
- Increasing water intake: Water helps food pass through the digestive tract and may help reduce constipation.
- Eating smaller meals: A doctor may recommend switching your child to smaller meals and foods that contain carbohydrates from whole grains, fruits, and vegetables.
They may also recommend avoiding certain foods and drinks known to worsen IBS.
Avoid eating or drinking these:
- caffeinated beverages
- dairy products if they make symptoms worse
- foods like beans and cabbage, if they cause your child to have gas
- foods with a lot of caffeine added
- high fat foods like processed or fast foods
Over-the-counter treatments
Doctors may recommend adding certain over-the-counter products or supplements, depending on the type of IBS your child has. This can include:
- Enemas or laxatives: Doctors may recommend using an enema or a laxative if your child is experiencing severe constipation. Do not give your child one of these products unless their pediatrician tells you to.
- Probiotics: Probiotics are microorganisms found in the GI tract. You can take probiotic supplements in capsule, powder, or tablet form, which may reduce the symptoms of IBS in some children. Or they can consume foods that naturally contain them, like yogurt and sauerkraut.
- Peppermint oil: Researchers found that taking enteric-coated peppermint oil may support gut bacteria. Some people use it to treat IBS symptoms, and it’s
generally considered safe. However, it may cause side effects like heartburn.
Other lifestyle changes
A doctor can recommend lifestyle changes depending on the cause and type of IBS. This can include:
- exercise to promote regular bowel movements
- mental health support for stress, anxiety, or depression and to learn relaxation and emotional regulation techniques
- designating a time in a child’s daily routine to try to have a bowel movement
Medications
Your doctor may prescribe medications depending on your child’s key symptoms. Examples of these medications may include:
- antidepressants, if a child is diagnosed with depression, which may potentially reduce GI tract activity in low dosages
- antidiarrheal medications like loperamide (Lomotil)
- antispasmodics to reduce cramping
- fiber supplements
- stool softeners or laxatives (to be used sparingly)
To determine the best treatment for your child’s IBS, their doctor will need to learn more about their symptoms and make sure it’s not related to another GI disease like ulcerative colitis or Crohn’s disease.
During the appointment, their doctor will perform a physical exam and ask questions about their symptoms to help differentiate the condition. These include questions about what makes the symptoms worse (or when they get worse) and what makes them better.
To receive a diagnosis of IBS, a child must have experienced abdominal pain
Tests to help with the diagnosis
A doctor may recommend testing to rule out GI diseases that could cause similar symptoms. The diagnostic tests often depend on the child’s symptoms.
Examples of these tests include:
- stool samples to identify if blood is present in the stool (IBS shouldn’t cause blood in the stool)
- colonoscopy or sigmoidoscopy to see the bowel and determine if there’s any damage to the intestinal lining (IBS shouldn’t cause intestinal damage)
- ultrasound to see the intestines and determine if their movement is irregular
IBS is a set of symptoms and not a disease, but it can still affect a child’s GI health long term. While there’s no cure for IBS, lifestyle changes and medication can help your child manage their symptoms.
You may need to try a few different treatments before finding the most effective combination for your child. During this time, it’s important to ask your child how they’re feeling and follow up on any concerns with their doctor in case they need to adjust your child’s treatment plan.