Irritable Bowel Syndrome (IBS) in Children and Teens

What is irritable bowel syndrome?  Irritable bowel syndrome (IBS, also known as a spastic colon) is a frequent problem in adults, and a not infrequent one, in school children.  The widely accepted criteria established by a group of international physicians meeting together in Rome (and thus called the Rome criteria) helps to define the condition.

Recurrent abdominal pain or discomfort at least 3 days/month in the last 3 months with two or more of the following:

  • Improvement of pain with a bowel movement
  • Associated with a change in the frequency of bowel movements
  • Onset associated with a change in form (appearance) of the bowel movement

Often, the pain or discomfort is more frequent and it can be “I-think-I-am-going-to-die”  intense.  The critical part is the bowel movements are different than they usually are--either more and usually loose (called IBS-D for diarrhea), IBS-C for constipation, IBS-M (mixed, meaning the bowel movements are different but they vary), or IBS-U for those that aren't yet typed.

The percentage of adults who have the different types are about equal, except that there aren't many who have the mixed type (going back and forth from constipation to diarrhea).  A recent study (Clin Gastroenterol Hepatol 2014; 12: 1468-73) evaluated 129 subjects between theages 7 and 18 who met the Pediatric Rome III IBS criteria (that's the newest version).  The key finding was that

  • IBS with constipation (IBS-C) was the most common subtype (58.1%);
  • IBS -U (the untyped) was next at 34.1%,
  • then IBS with diarrhea (IBS-D) at 5.4%, and
  • least common was mixedIBS (IBS-M) at 2.3%

The Take-home message, as Dr. Jay Hochman points out in his blog, gutsandgrowth : Among patients who have been labelled as having constipation, many, in fact, have IBS-C and may have persistent gastrointestinal symptoms despite the use of laxatives.

The good news is that a High Fiber Diet often helps in both constipation, when it occurs by itself and in IBS-C.  But in IBS-C, you may want to use our Symptom Diary to sort out other factors that may be contributing to the problem (like stress or other dietary factors, or a lack of exercise); and if a High Fiber Diet doesn't help, you may want to talk to your doctor about the low FODMAP diet that has been helpful for many patients with IBS.

Dr. Stan Cohen 27 October 2015

Dr. Stan Cohen is one of our founders and our CEO as well as the Chairman of our Medical Advisory Board. Dr. Stan is an internationally recognized expert in pediatric gastroenterology and nutrition. He is a Read More

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