Posted 3/14/2018 by UHBlog
When should you take your child’s bellyaching seriously? Ask us.
The common cold tops the list of reasons kids miss school. But the second most cited cause for a sick day is a tummy ache.
Most of the time a child’s tummy trouble comes from anxiety, dipping too heavily into the cookie jar, or a stomach bug. But in some cases that stomachache is indicative of something more – like irritable bowel syndrome (IBS).
“When a child has abdominal pain accompanied by changes in bowel patterns for four days a month over a two-month span, those symptoms could suggest irritable bowel syndrome (IBS),” says pediatric gastroenterologist Ramy Sabe, MD. “If your child has these symptoms, it’s best to see a specialist as early as possible to get IBS diagnosed and under control, and to rule out more serious disorders like celiac disease, Crohn’s Disease or ulcerative colitis.”
According to Dr. Sabe, IBS can affect anywhere from 5 percent to 35 percent of kids. Its symptoms include:
- Diarrhea: Passing loose, watery stools three or more times a day
- Constipation: Hard, dry stools; two or fewer bowel movements a week; straining to have a bowel movement
- Alternating between diarrhea and constipation
Although there is no definitive test to diagnose IBS, doctors can make an appropriate diagnosis by listening to children describe their symptoms in detail.
“We can learn a lot by having children honestly describe what is going on,” says Dr. Sabe.
The most common ways to treat IBS in children are with diet and medications to control the pain and associated symptoms.
“If children have frequent diarrhea, we give them an antidiarrheal, and if they are constipated, we prescribe laxatives,” he says. “Other therapies and treatments for pediatric IBS that we consider are cognitive behavioral therapy, hypnotherapy and probiotics.”
Dr. Sabe recommends following a Low-FODMAP diet, which eliminates or reduces sugars in the diet that are fermentable by gut bacteria like wheat, garlic, onions, fresh apples and pears and high fructose corn syrup. FODMAP is an acronym that refers to these fermentable foods.
Although the food triggers for IBS can be different for each child, foods that may prompt IBS symptoms are:
- Spicy foods
- High-fat foods
- Some dairy products
- Big, heavy meals
Although heavy antibiotic use in children has gotten a lot of negative press as an IBS culprit, Dr. Sabe says that may not be the case.
“Even though we don’t know the exact reason children develop IBS, we don’t have enough evidence to prove that antibiotic use in children makes them more predisposed to developing IBS,” he says.
The good news, says Dr. Sabe, is that IBS, which affects more girls than boys, is a functional disorder that children will usually outgrow in adulthood. And the condition doesn't impair a child’s ability to grow and develop normally.
The goal of a gastroenterologist is to “control a child’s IBS symptoms so they can go back to school and lead a normal life,” says Dr. Sabe. “And to ensure there is no other underlying organic gastrointestinal disorder.”
Ramy Sabe, MD is a pediatric gastroenterologist at University Hospitals Rainbow Babies & Children’s Hospital. You can request an appointment with Dr. Sabe or any other doctor online.