Childhood tummy aches are nothing surprising — until it becomes clear they're being caused by something more serious than overindulgence on candy. Irritable bowel syndrome or IBS is most familiar as an adult disease, but that doesn't mean that kids can't also get it, making their sore stomachs a source of pain and embarrassment rather than just a convenient way to get out of school.
IBS can affect both children and adults, says children's health expert Dr. Carolyn Dean, with about 14 per cent of high school students and six per cent of middle school students complaining of IBS-like symptoms. But it's important to remember that children with IBS are not just smaller humans with the condition, Dean says. "Children are not mini-adults, especially when it comes to IBS. They may have the same symptoms of IBS that adults suffer, but they don't have the coping mechanisms that tend to come with maturity."
Read on to learn more about IBS — and specifically, about what the condition means for children, and how it can be managed.
What is IBS? IBS occurs when the process of absorbing nutrients and water from food and having a bowel movement is somehow interrupted, according to KidsHealth. This means that the contents of the colon can't move along as they should, which can lead to an elimination process that stops and starts, moves too quickly, or doesn't move at all. This can result in a lot of discomfort, and even pain, as well as some embarrassing rushes to the bathroom.
Is it IBS? "Tummy pains are common in children, which means it's tough for them — and their parents — to know when the problem is IBS," Dean says. And most kids will experience either diarrhea or constipation at some point during childhood, for a variety of reasons. What makes IBS different is the consistency of the symptoms — this isn't just a stomach ache that occurs every couple of months. Your doctor may also ask about things like what helps their stomach pain, how frequently they report having a stomach ache, what your child's bowel movements are like, and how often your child has a bowel movement.
What causes it? The exact cause of IBS is not yet known. The condition does appear to run in families, though it's not known why. Some of the potential causes could include GI motor problems, mental health problems, hypersensitivity, or genetics, according to the National Institutes of Health.
Can babies get IBS? IBS can occur in children of all ages, though the symptoms may differ by age, according to Stanford Children's Health. In babies and toddlers, symptoms could include colic, gastroesophageal reflux, and chronic and non-specific diarrhea.
What triggers IBS symptoms? The triggers for IBS will differ from child to child, just as they do from adult to adult. For some children high-fat foods can be a problem, while excess sugar or soda pop can be for others. Keeping a food diary of your child's symptoms can help you decipher which foods are more likely to contribute to their condition.
Don't discount their emotions: Just as in adults, emotional stress can trigger IBS symptoms. But Dean says it's important to remember that children, biologically and psychologically, have fewer resources to manage those emotions — and therefore reduce their symptoms. "Embarrassment about bodily functions makes it difficult for children to talk about this condition," she says, noting that it can add to their emotional distress and discomfort.
Give kids a way to manage stress: Because stress and high emotions can exacerbate IBS symptoms, it can help to give your children the emotional tools they need to manage stress. For example, your child may find that mindfulness practices can help them control stress and avoid a flare up, or that physical activity improves their mood. Talk to your child about their feelings, and about what helps them feel calmer.
Consider portion control: Eating smaller portions more frequently can help control IBS symptoms, so help your children have the ability to do that. Remember that being expected to clear a full plate at meals may actually be bad for their health and adjust meal times and portions accordingly. Children tend to enjoy eating small, frequent meals and snacks, Dean says, so this lifestyle change is one that your child might take to quite readily. Making sure these meals are balanced can help ensure your child meets nutritional goals, as can monitoring of their growth and blood work.
Reduce inflammation: IBS is a symptom of inflammation, so getting that under control is part of how the condition can be managed. "Anything you can do to reduce inflammation is helpful in managing IBS for kids and adults alike," says Stacie Haaga, a registered dietitian. "My first step in addressing inflammation and IBS symptoms is always to remove foods that trigger inflammation through an elimination diet," Haaga says, "either using a food sensitivity test like Mediator Release or an elimination diet of the most common offenders." Reducing the inflammation can help the gut begin to heal, she says.
Give them soluble fibre: "Offer him applesauce and mashed potatoes, which rate high on the list of soluble fibre foods that soothe the tummy," Dean says. "A breakfast of a soluble fibre food, like cooked oats or barley, along with diluted orange juice or apple juice may be a good choice. You have to experiment to find out what affects your child in good and bad ways."
Get your child involved: Encourage your child to be part of their treatment, in age-appropriate ways. For example, you can encourage your child to be a "detective" by reporting how they feel after eating certain foods, in order to discover which ones contribute to their symptoms. Older children can help plan and cook meals and track their symptoms. And as mentioned above, helping your child develop stress-management techniques can also help keep their symptoms at bay.