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Irritable Bowel Syndrome in Children

Robert Rothbaum, MD
Dr. Robert Rothbaum
treats patients at

St Louis Children's Hospital
One Children's Place, 2nd Floor, Suite C
St. Louis, MO 63110

Phone:  314-454-6173    Fax: 314-454-2412
 _________________________________________

Question:  Periodically, my 12-year-old son has cramps in his lower abdomen, often in the middle of a meal or when he wakes up in the morning. He gets the urge to have a bowel movement, which varies from loose to hard. What causes these symptoms? 

Answer:  Your son most likely has irritable bowel syndrome (IBS). The symptoms arise from the stretching or contracting of the muscle in the wall of the colon or large intestine. IBS creates discomfort but does not represent any serious internal event. Certain activities increase the muscle activity of the colon, such as eating, starting the day’s routine and emotions or worries.
 
The urge to have a bowel movement can be intense, starting a quick search for a bathroom. The unpredictable variation between liquid and solid stools is common. The pain is most often relieved by passing a stool. These symptoms can be bothersome during the day, but generally do not interrupt sleep. IBS is also known as spastic colon or mucous colitis.
 
People with IBS are very sensitive to internal sensations in the gastrointestinal tract. They often feel reflux of fluid from the stomach into the esophagus and bloating or fullness in the abdomen.

IBS is not an allergy to any food, but some foods make the symptoms more prominent. Fatty foods and dairy products are the most common offenders. IBS is not an infection, but it may follow one. Family members may also have similar symptoms.

When we see a child with IBS, two other diagnoses are considered. Celiac disease (CD) is a sensitivity to wheat and wheat products. CD affects about one person in 300. A second potential problem is inflammatory bowel disease (IBD, Crohn’s disease or ulcerative colitis).

Most children with IBD have additional symptoms, like bleeding, weight loss, or night-time diarrhea. A careful physical exam and selected blood tests provide additional findings. A definitive diagnosis requires more invasive tests like colonoscopy or x-ray studies.

Treatment for IBS symptoms consists of education and simple adjustments to diet. Identification of stressors and counseling to reduce stress are useful. Consultation with your primary caregiver or with a gastroenterologist will provide the best guidance.
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Copyright 2014 Washington University School of Medicine