When it’s More Than a Stomachache

Your 12-year-old son seems perfectly healthy, but during stressful situations, he complains of abdominal pain, gas and diarrhea. Could he have irritable bowel syndrome (IBS)?

As a parent, you have no doubt heard your child complain of stomachaches on occasion. Sometimes you might dismiss this if you know your child is trying to get out of something, such as a big test at school, or is feeling anxious about a presentation she has to give.

On the other hand, if your child complains of stomach pain, bloating, cramping, diarrhea, constipation or gas for 12 weeks or longer within a one-year period of time, he may have IBS—a digestive disorder that’s not dangerous and doesn’t lead to long-term problems, but which may cause him to feel miserable nonetheless.

“IBS isn’t progressive or damaging; it’s simply the way that some children’s intestinal systems work,” says Robert Rothbaum, MD, pediatric gastroenterologist at St. Louis Children’s Hospital. “Children with IBS have exceedingly sensitive intestines, which react to food, gas or stress by producing painful muscle spasms. The first thing parents should do is make an appointment with their child’s pediatrician to rule out any other diseases that may be causing symptoms.”

Why Does It Happen?

To understand IBS, you must first understand how digestion works. After food is processed in the stomach, it moves from the small intestine to the large intestine, also called the “colon,” before exiting the body. As food leaves the body during a bowel movement, one of two things can happen: either the muscles in the colon squeeze too hard, making the food move more quickly than usual, causing diarrhea; or the muscles don’t squeeze hard enough, which means food moves too slowly and results in constipation.

“While there’s currently no known cause of IBS,” says Jay Epstein, MD, pediatrician on staff at ?St. Louis Children’s Hospital, “we can treat the symptoms, making kids more comfortable during IBS episodes.”

Getting a Diagnosis

According to the National Digestive Diseases Information Clearinghouse, along with the symptoms mentioned at the beginning of the article, children with IBS also experience at least two of the following:

• pain that’s relieved after a bowel movement occurs
• pain onset that occurs with fluctuations in the frequency of bowel movements
• pain onset that occurs with changes in stool consistency (diarrhea and/?or constipation)

“When I see a child with symptoms that are indicative of IBS, I perform a physical exam and run several different tests. After ensuring no other conditions are present, I make a diagnosis of IBS and then sit down with the family and talk,” says Dr. Epstein. “We focus mainly on education and discuss topics including the child’s diet and helpful stress-management techniques. With time and guidance, children learn to manage their conditions and experience less discomfort.”

Treating Symptoms

Along with lifestyle changes—such as avoiding problematic foods, learning to adapt to stress or anxiety and sticking to a low-fat, high-fiber diet—physicians may also recommend medication. Fiber supplements, laxatives, anti-diarrhea medication, medication to control muscle spasms and muscle relaxants are all options, depending on the severity of symptoms and your child’s individual condition.

“Parents should understand that IBS doesn’t threaten their child’s health, but it may affect his life,” says Dr. Rothbaum. “Take his complaints and feelings seriously and help him through the difficult times. Once he learns to cope with the condition, your relationship will be stronger and he’ll be back in the swing of things in no time.”