Doctors’ Notes

Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a common, chronic condition that affects the large intestine.

It’s more common in girls than boys and typically begins in late teens or early 20s. It’s a separate condition from inflammatory bowel disease and is not related to other bowel conditions. It does not cause changes in bowel tissue or increase your child’s risk of colorectal cancer.

Causes

There’s no specific cause of irritable bowel syndrome, but there are a number of theories about what influences it. IBS is known to be related to diet, psychosocial factors (like stress and anxiety), and intestinal motility issues.

DIET

Food intolerances are common in patients with IBS, which raises the possibility that it’s caused by food sensitivity or allergy. A number of foods are known to cause symptoms that mimic or aggravate IBS, including dairy products (which contain lactose), legumes (such as beans), and cruciferous vegetables (such as broccoli, cauliflower, Brussels sprouts, and cabbage). These foods increase intestinal gas, which can cause cramps.

PSYCHOSOCIAL FACTORS

Stress and anxiety are known to affect the intestine, so it’s likely that anxiety and stress can worsen your child’s symptoms. However, stress or anxiety are probably not the underlying cause, just a contributing factor.

MOTILITY

Chemical imbalances in the intestine can cause abnormal movement or contraction and spasm of the intestine, which leads to abdominal pain and cramping.

Symptoms

The most common symptom of IBS is recurrent abdominal pain. Now, we all know abdominal pain is a pretty common thing, but there are certain characteristics of pain that go along with IBS — especially abdominal pain that occurs after your child has eaten and is relieved after a bowel movement. Because IBS is a chronic condition, we usually say this pain has to occur pretty regularly — at least once a week for around 3 months.

Other symptom of IBS your child may experience are changes in bowel habits, cramping, bloating, and excess gas. Your child may also experience constipation, diarrhea, or a combination of both. The biggest keys in identifying IBS are a pattern of symptoms and the food your child eats. Their symptoms will typically occur after meals and may fluctuate depending on what they ate.

Management

The most effective management of IBS is lifestyle change. You can encourage your child to:

Eat a high-fiber diet
Drink plenty of water (enough so urine is light in color)
Get at least 30 minutes of exercise per day, outside when possible
Get at least 8 hours of sleep each night
Avoid processed foods
Avoid any foods you or your child have noticed trigger symptoms

Some patients find it helpful to avoid other things such as foods containing fructose, sorbitol, dairy or gas producing foods. It’s best to work with your provider to determine what the best food choices are for your child. It may be helpful to see a nutritionist to aid in creating a healthy nutrition plan. It’s important to pay attention to what foods you restrict, so your child maintains a diet with all the necessary vitamins, minerals and nutrients.

Probiotics may be helpful. You can discuss with your provider if this is right for your child.

It may also be important to work specifically on symptoms of anxiety that can trigger IBS symptoms. We can help you find a counselor if needed.

When to Call the Office

Irritable Bowel Syndrome does not usually have serious complications, but can be frustrating to live with unless symptoms are well managed. Call our office if your child is losing weight, experiencing persistent diarrhea or constipation, their pain is not improving with lifestyle changes, or if they (or you) see blood in their stool. And, of course, i you have questions or concerns, you can call us in the office any time.

Dr. Amy Maddalena, a Kids Plus Doc since 2006, teaches the Expectant Parent Orientation class at our Pleasant Hills office.

Kayla Klaus spent a rotation at Kids Plus as a PA Student from Slippery Rock University.