Irritable Bowel Syndrome (IBS)

6/6/2008

Does your child suffer from persistent

• Abdominal pain
• Bloating
• Cramping
• Constipation or diarrhea?

Does he or she spend hours in the bathroom trying to have a bowel movement? Does he or she suffer from urgent diarrhea on a regular basis?

If so, a trip to the pediatrician is called for to diagnose or rule out serious disorders such as Crohn’s disease, ulcerative colitis, celiac disease, and H. pylori infection. However, if everything looks normal in the physical exam and office or laboratory testing yet symptoms persist, the diagnosis may well be irritable bowel syndrome (IBS). The small and large intestines look normal, but their function clearly is not.

If the gut looks normal, what causes IBS? There may be many causes of IBS, depending on an individual’s genetics and metabolism. Some possibilities:

• Stress. The linings of the organs of the gastrointestinal system make up a second nervous system (the enteric nervous system) that contains nearly every compound that helps run the brain. It’s not surprising then that stress affects the workings of the gut so strongly. There is some thought that low levels of the mood-regulating neurotransmitter serotonin in the gut—which amazingly produces more serotonin than the brain—may be at least partly to blame.
• Diet. A typical Western diet low in fiber-rich whole grains, fruits, and vegetables may cause gut problems. In addition, proper function of the intestines can be affected by a food intolerance, sensitivity, or allergy.
• Antibiotics. The antibiotic drugs we take in through food and medications may upset the balance of the normal gut flora (good and bad bugs).

Here are my recommendations to relieve the symptoms of IBS:

1. Practice stress management. You can help a child ease stress with self-hypnosis, breathwork, exercise, and fun family outings.

2. Supplement with probiotics. The “good bugs” found in probiotic foods and supplements can help normalize gut bacteria, improve stool quality, and maybe reduce abdominal pain.

3. Try an elimination diet/food challenge. The easiest way to do a food challenge is to pick a food to which your child is most likely to be sensitive, like dairy or cereal grains, and then eliminate it completely from his diet for two weeks. Notice how he is feeling and acting at that time, and document symptoms each day. At the end of the trial, gently re-introduce the food into his diet. If there is a significant worsening of IBS symptoms, he may indeed need to reduce or eliminate it from his diet. If milk seems to be the culprit, you can buy dairy products especially processed for the lactose-intolerant.

4. Eat small, frequent meals, rather than two or three big meals. We’re not sure why this reduces symptoms, but it does.

5. Regular exercise to keep the intestinal system moving normally.

6. Add fiber to the diet with more fruits and vegetables. If symptoms worsen, do a food challenge to determine which food is causing the reaction.