April is Irritable Bowel Syndrome (IBS) Awareness Month. IBS is common with worldwide prevalence estimated at 9 percent to 23 percent. Yet, many people remain undiagnosed and unaware that their symptoms indicate a medically recognized disorder.
Irritable Bowel Syndrome is a common diagnosis in children.
When we hear about Irritable Bowel Syndrome (IBS), we may think of adults with cramping pain, but this is a condition that truly affects all ages. As pediatricians and pediatric gastroenterologists, we see children with IBS throughout childhood, though we see it more in adolescents and teenagers.
What is IBS? IBS is a gastrointestinal disorder. A patient will have chronic abdominal pain and see changes in his or her bowel habits. If this sounds vague and broad, that’s because it is. IBS can present in children in many ways, including abdominal pain, bloating, gas pain, changes in appetite, constipation, diarrhea, or alternating constipation and diarrhea. In all children with chronic abdominal pain, IBS is the most common diagnosis.
Receiving the diagnosis of IBS is a mixed bag of feelings; patients are glad that they don’t have a serious inflammatory condition, but is the physician saying it’s all in their head? No! There is a lot of research that suggests that there are a lot of complicated mechanisms involved in the pain, bloating, and stooling difficulties people feel related to IBS.
What IBS is not: IBS is not caused by chronic inflammation of the bowel like Inflammatory Bowel Disease (known as IBD). People often get the two confused. They are very different conditions. IBS does not cause damage to the intestinal lining and system. People with IBS do not experience significant weight loss or blood in their stools. Generally, people with IBS have normally functioning intestines, but the way their intestines handle food, bacteria, gas, and the sensitivity of their intestines to pain is different than people without IBS.
Not all abdominal pain is IBS.
Up to 75 percent of teenagers report having abdominal pain at some point in the prior year. Not all of these children have IBS, but around 15 percent of teenagers with IBS report having weekly pain. One-fifth of those teens have pain that limits their activity level.
IBS can significantly affect a child’s ability to go about his or her daily life.
Children with IBS and their parents report a decreased quality of life. Although the symptoms of IBS are not damaging to the body, they can significantly affect a child’s interest in food, their ability to pay attention in school and to be active in play and sports. Children with active IBS symptoms report a similar quality of life to children with chronic, severe GI diseases like Celiac disease and Crohn’s disease. Children with IBS are more likely to also have an anxiety disorder or depression. IBS symptoms can often result in missed school days, decreased play and activities, and can affect their parents’ ability to work.
There are different management strategies that can help with IBS symptoms.
So much of the therapies in IBS revolve around significantly changing the way you live life, which is easier said than done. Luckily, most of these changes involve living a healthy lifestyle—exercising, eating healthy foods (Read this blog article), drinking lots of water, avoiding triggers, and trying to find ways to cope with stress. There is also data to suggest that certain probiotics can help with symptoms. Children occasionally need medications for more severe days, but unfortunately, those medications don’t work for everybody.
When you find the right strategies to help you control your IBS symptoms, you can have significant improvement in your quality of life!
Pamela Puthoor, MD, is a pediatric gastroenterologist at The University of Vermont Children’s Hospital and an assistant professor in the Department of Pediatrics at the Larner College of Medicine at UVM.
- Hyams, JS, et al. Abdominal pain and irritable bowel syndrome in adolescents: a community based study. Journal of Pediatrics. Aug 1996. vol.129(2); pg 220-226.
- Varni, JW, et al. Health-related quality of life in pediatric patients with functional and organic gastrointestinal diseases. Journal of Pediatrics. Jan 2015. vol.166(1); pg 85-90.
- Rutten, JM, et al. Nonpharmacologic treatment of functional abdominal pain disorders: a systematic review. Pediatrics. Mar 2015. vol.135(3); pg 522-533.