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Irritable Bowel Syndrome

What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a chronic disorder causing annoying and often painful abdominal and bowel symptoms. IBS is considered a functional bowel disorder, meaning that, although symptoms are clearly present, when the bowel is examined visually and under the microscope, there is no evidence of damage to the tissues. Symptoms include,

  • bloating
  • cramping
  • chronic or intermittent diarrhea
  • chronic or intermittent constipation
  • urgency with defecation
  • incomplete sensation of defecation
  • passage of mucus in the stool

What causes irritable bowel syndrome?

The digestion and propulsion of nutrients and fluids through the gastrointestinal system (GI) is a very complicated and very well organized process. The GI tract has its own intrinsic muscles and nerves that connect, like an electrical circuit, to the spinal cord and brain. Neuromuscular events occurring in the GI tract are relayed to the brain through neural connections, and the response of the brain is also relayed back to the gastrointestinal tract. As a result of this activity, motility and sensation in the bowel is generated. An abnormality in this process results in a disordered propulsion of the intestinal contents and generates the sensation of pain. Children may experience the symptoms of IBS due to

  • mobility abnormalities 
  • hypersensitivity of the inside of the bowel to stretching and motion
  • stress
  • overgrowth of bacteria in the bowel

All of the above factors can trigger the occurrence of symptoms. It is important to stress to the child with a functional bowel disorder that his or her abdominal pain is real and not imaginary.

Who is affected by irritable bowel syndrome?

  • Children and adults. Almost 14 percent of high school students and 6 percent of middle school students complain of IBS-like symptoms.
  • Girls and boys are equally affected by the disorder.
  • There is no known gene that causes IBS, but the disorder does seem to occur more often in families where either a child or a parent has the disorder.

What are the symptoms of irritable bowel syndrome?

  • recurrent abdominal pain. the pain becomes chronic when it has been present for a period greater than three months.
  • an altered bowel pattern with diarrhea and constipation, all of which suggest intestinal motility problems.
  • nausea
  • dizziness
  • loss of appetite
In children, symptoms of functional bowel disorders are variable and are age dependent. For example

  • infantile colic (younger than 4 months of age)
  • gastroesophageal reflux (younger than 2 years of age and then reappears in adolescence and adulthood)
  • chronic nonspecific diarrhea (younger than 4 years of age)
  • constipation (any age)
  • irritable bowel syndrome (adolescents and adults)

How is irritable bowel syndrome diagnosed?

  • blood tests - tests to evaluate whether your child is anemic, has an infection, or has an illness caused by inflammation or irritation.
  • urine analysis and culture - These are done to help assess for urinary tract infections.
  • stool sample - This sample is taken to culture to check for bacteria and parasites that may cause diarrhea.
  • stool samples for occult blood - They cannot be seen and is only detected by a special solution that turns blue when coming into contact with blood.
  • lactose breath hydrogen test - This test is done to determine if your child is intolerant to lactose, a sugar present in milk and milk products.
  • abdominal x-ray - A simple study that will give the health care provider an idea of how the internal organs look.
  • abdominal ultrasound -  A diagnostic imaging technique which creates images from the rebound of high frequency sound waves in the internal organs.
  • endoscopy - A test that uses a small, flexible tube with a light and a camera lens at the end to examine the inside of part of the digestive tract. Tissue samples from inside the digestive tract may also be taken for examination and testing.
  • colonoscopy - A test that uses a long, flexible tube with a light and camera lens at the end to examine inside the large intestine.

What is the treatment for irritable bowel syndrome?

Specific treatment of IBS will be determined by your child's health care provider based on

  • your child's age, overall health, and medical history
  • extent of the problem
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

The main objective of treatment for IBS is to restore normal daily function. Management begins with the positive diagnosis of IBS. This will give your child reassurance that he or she does not have any life-threatening condition. Treatment may include dietary changes, medication, and stress management.