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Johns Hopkins All Children's Hospital







Irritable Bowel Syndrome (IBS)

Overview

What Is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is a common intestinal problem that affects the colon (the large intestine). It can cause cramps, gas, bloating, diarrhea, and constipation. It's sometimes called a "nervous stomach" or "spastic colon."

IBS can be uncomfortable and embarrassing, but it doesn't cause serious health problems. Doctors can help kids and teens manage IBS symptoms with changes in diet and lifestyle. Sometimes they prescribe medicines to help relieve symptoms.

Top Things to Know

  • Irritable bowel syndrome (IBS) is a common digestive condition that affects how the colon works and can cause ongoing belly discomfort.
  • Kids with IBS may have belly pain, bloating, gas, diarrhea, constipation, or changes in bowel habits.
  • IBS is managed with changes in diet, lifestyle, stress management, and sometimes medicine.
  • IBS can be confused with other digestive problems or dismissed as “just a nervous stomach,” but symptoms are real and often linked to stress, food triggers, or gut sensitivity.

What Happens in IBS?

Normally, the colon absorbs water and nutrients from partially digested food. Waste products aren't absorbed, and move slowly through the colon toward the rectum. Then, they leave the body as feces (poop).

Muscles in the colon help the body do this. They squeeze and relax as they push undigested food through the large intestine. They work with other muscles in the rectum or pelvis to push feces out of the anus.

But with IBS, the colon's muscles don't work at the right speed for good digestion or don't work well with the other muscles. Undigested food in the colon can't move along smoothly. This can lead to belly cramps, bloating, constipation, and diarrhea.

Signs & Symptoms

What Are the Signs & Symptoms of IBS?

The main sign of IBS is belly pain or discomfort. Other signs include:

  • changes in bowel habits (pooping)
  • bloating
  • belching (burping)
  • flatulence (farting)
  • heartburn
  • nausea (sick to the stomach)
  • feeling full quickly when eating

But having gas or a stomachache once in a while doesn't mean someone has IBS. Doctors consider it IBS when symptoms last for at least three months and include at least two of these signs:

  • pain or discomfort that feels better after a bowel movement (BM)
  • pain or discomfort together with changes in how often a person has to go to the bathroom
  • pain or discomfort along with changes in their stool (poop). Some people get constipated, and their poop is hard and difficult to pass. Others have diarrhea.

Causes

What Causes IBS?

The specific cause of IBS isn't known, but it tends to run in families.

Some foods — like milk, chocolate, drinks with caffeine, gassy foods, and fatty foods — can trigger IBS symptoms. So can infections, anxiety, and stress. Some kids with IBS are more sensitive to emotional upsets. Nerves in the colon are linked to the brain, so things like family problems, moving, or taking tests can affect how the colon works.

Kids with IBS may be more sensitive to belly pain, discomfort, and fullness than other kids. Sometimes, people never find out what brings on their IBS symptoms.

Diagnosis

How Is IBS Diagnosed?

There is no specific test for IBS. To diagnose it, doctors ask about symptoms and do an exam. They'll ask if anyone in the family has IBS or other gastrointestinal problems.

Talking about things like gas and diarrhea can be embarrassing for kids. Reassure your child that the doctor deals with issues like this every day and needs the information to help your child feel better.

The doctor may suggest keeping a food diary to see if any foods trigger your child's IBS symptoms. The doctor might ask about stress at home and at school.

Most of the time, doctors don't need medical tests to diagnose IBS. Sometimes they order blood tests, stool tests, X-rays, or other tests to be sure another medical problem isn't causing the symptoms.

Treatment & Care

How Is IBS Treated?

There's no cure for IBS. But many things can help reduce IBS symptoms, including:

  • Changes in eating. Some kids find that careful eating helps reduce or get rid of IBS symptoms. Your child might have to avoid milk and dairy products, caffeine, greasy foods, spicy foods, gluten, sugary drinks, or other foods that seem to bring on problems. Eating smaller, more frequent meals also might help.
  • Changes in lifestyle. If IBS is tied to stress, talk about what your child can do to manage pressures related to school, home, or friends.
  • Regular exercise. Exercise can help digestion. It's also a great stress reliever.
  • Medicines. Doctors sometimes prescribe medicines to treat diarrhea, constipation, or cramps. Antidepressants may help some people with pain management and depression. Talk with your doctor before giving your child any over-the-counter medicines for diarrhea, constipation, cramps, or other digestive problems.
  • Counseling and coping strategies. If your child seems very anxious or depressed, your doctor might recommend seeing a psychologist or therapist. Therapy, hypnosis, breathing exercises, or other relaxation techniques can help some people manage IBS.

IBS can affect your child's quality of life. Talk with your doctor about ways to manage it to help your child lead an active and healthy life.

Medically reviewed by: J. Fernando del Rosario, MD
Date reviewed: May 2023