Irritable Bowel Syndrome 

(IBS) in Children 

National Digestive Diseases Information Clearinghouse 

U.S. Department 

of Health and 

Human Services 

NATIONAL 

INSTITUTES 

OF HEALTH 

What is irritable bowel 

syndrome (IBS)? 

IBS is a functional gastrointestinal disorder 

marked by abdominal pain or discomfort, 

bloating, and irregular bowel habits, such 

as diarrhea or constipation. Functional 

gastrointestinal disorders are defi ned by 

their symptoms. IBS can cause a great 

deal of discomfort and distress, but it is 

not life threatening, does not damage the 

bowel, and does not progress to other 

diseases. IBS should not be confused with 

inflammatory bowel disease (IBD), a group 

of diseases including ulcerative colitis and 

Crohn’s disease. 

What is the bowel? 

The bowel is the section of the gastrointestinal tract that begins after the stomach, ends 

at the anus, and has two main sections: the 

small intestine and the large intestine—also 

called the colon. 

What causes IBS? 

The cause of IBS is unknown. Research 

suggests people with IBS are more sensitive 

to gas or stool in the colon. People with IBS 

can also have abnormalities in how their 

intestines contract, called motility, which 

refers to the rate stool moves through the 

intestines. Whereas a faster rate of movement may cause diarrhea, a slower rate may 

result in constipation. 

Liver 

Small 

intestine 

Stomach 

Anus 

Large 

intestine 

Esophagus 

The bowel has two main sections: the small intestine 

and the large intestine. 

Researchers have proposed many explanations for the increased bowel sensitivity and 

abnormal bowel motility associated with IBS, 

such as 

• reactions to certain foods 


• overgrowth of bacteria in the colon
 

• 	 psychological stress, including anxiety 

and depression 
 

• 	 problems in the way the brain and the 

gastrointestinal tract communicate 

with each other, called the brain-gut 

connection 

Who gets IBS? 

IBS is common in people of all ages, including children. About 14 percent of high 

school students and 6 percent of middle 

school students report IBS-like symptoms.1 

IBS affects boys and girls equally, although 

in adults it is more common in women than 

in men. 

What are the symptoms of 

IBS? 

The frequency and severity of IBS symptoms 

vary widely and may include 

• 	 abdominal pain or discomfort 

• 	 intestinal bloating 

• 	 irregular bowel habits, including diarrhea, constipation, or both 

• 	 a change in the appearance of stool, 

including stools that are loose, hard, 

thin, or pelletlike 

• 	 mucus in the stool 

• 	 the need to strain to have a bowel 


movement
 

• 	 a sense of urgency when having a bowel 

movement 

• 	 the sensation of not completely emptying the bowels 

1Hyams JS, Burke G, Davis PM, Rzepski B, Adrulonis 

PA. Abdominal pain and irritable bowel syndrome in 

adolescents: a community-based study. The Journal of 

Pediatrics. 1996;129(2):220–226. 

How is IBS diagnosed? 

IBS is diagnosed based on symptoms. A 

diagnostic manual called Rome III guides 

doctors in diagnosing and treating functional 

gastrointestinal disorders, including IBS. 

According to Rome III, for a child to be diagnosed with IBS, abdominal pain or discomfort must be present at least 1 day per week 

for a period of 2 months or longer. Two or 

more of the following must also occur at least 

25 percent of the time: 

• 	 The pain or discomfort is relieved by 

having a bowel movement. 

• 	 The pain or discomfort is associated with 

an increase or decrease in the number of 

bowel movements. 

• 	 The pain or discomfort is associated 


with a change in the appearance of 


stool. 


No test can show if a person has IBS; however, a doctor may run tests to rule out 

diseases with symptoms similar to IBS. Signs 

and symptoms that suggest a problem other 

than IBS include 

• 	 persistent pain in the upper right or 


lower right area of the abdomen
 

• 	 diffi culty swallowing 

• 	 persistent vomiting 

• 	 gastrointestinal bleeding 

• 	 waking up during the night with diarrhea or because of abdominal pain 

• 	 a family history of IBD, celiac disease, 

or peptic ulcer disease 

• 	 arthritis 

• 	 infl amed, pus-filled masses around the 

rectum, also called perirectal disease 

• 	 involuntary weight loss 

2 Irritable Bowel Syndrome (IBS) in Children 
• 	 a sudden stop in height growth 

• 	 delayed puberty 

• 	 unexplained fever 

How is IBS treated? 

No cure for IBS exists; however, treatment 

can reduce symptoms. Treatment is guided 

by the symptoms present, their severity, and 

the child’s response to treatment. Treatment 

includes dietary changes, medication, and 

stress management. 

Dietary Changes 

• 	 Reducing or eliminating certain foods 

may improve symptoms. Common 

trigger foods include fatty foods, dairy 

products, carbonated beverages, and 

caffeine. Keeping a diary of symptoms, 

bowel habits, and diet may help identify 

foods that trigger IBS symptoms. 

• 	 Eating high-fiber foods, such as fruits, 

vegetables, and whole grain breads 

and cereals, may also help. Fiber helps 

relieve constipation and promotes 

regular bowel movements. 

• 	 Eating several small meals throughout 

the day instead of a few large ones may 

reduce symptoms. 

Medications to Control 

Constipation and Diarrhea 

• 	 Fiber supplements, such as Metamucil 

or Citrucil, help control constipation. 

• 	 Laxatives, such as PEG 3350 (MiraLax, 

GlycoLax), mineral oil, or bisacodyl 

(Dulcolax), relieve moderate to severe 

constipation. 

• 	 Loperamide (Imodium) and bismuth 

subsalicylate (Pepto-Bismol) help 

relieve diarrhea. 

• 	 Antispasmodics, such as dycyclomine 

(Bentyl), relax smooth muscle contractions in the bowel and can, theoretically, 

lessen pain related to IBS but should 

be used with caution due to potentially 

serious side effects. 

• 	 Antidepressants, including selective 

serotonin reuptake inhibitors (SSRIs) 

and tricyclic antidepressants (TCAs), 

are used to treat IBS, although their 

effectiveness in children is not well 

documented. 

Before taking any of these medications, children and their parents should seek the advice 

of a health care provider to help weigh the 

potential benefits against the risk of possible 

side effects. 

Stress Management 

Understanding that IBS is not a lifethreatening disease can help reduce a 

child’s anxiety, which may in turn lessen 

IBS symptoms. Certain types of counseling, 

including cognitive behavior therapy and 

hypnotherapy, have been shown to help 

manage IBS symptoms. Parents can help 

reduce a child’s stress by discussing potential 

IBS-related issues with school personnel—for 

example, the need for ready access to a 

private restroom. 

3 Irritable Bowel Syndrome (IBS) in Children 
What is the outlook for a 

child with IBS? 

IBS symptoms typically fluctuate. Symptoms 

may go away for a long period of time only to 

return for no obvious reason. The majority 

of people with IBS continue to report symptoms 5 years after initial diagnosis. 

Points to Remember 

• 	Irritable bowel syndrome (IBS) is a 

functional gastrointestinal disorder 

marked by abdominal pain or discomfort, bloating, and irregular bowel 

habits. 

• 	IBS is common in people of all ages, 


including children.
 

• 	 Treatment for IBS includes dietary 


changes, medication, and stress 


management. 


• 	IBS can cause a great deal of discomfort 

and distress, but it is not life threatening, 

does not damage the bowel, and does 

not progress to other diseases. 

Hope through Research 

The National Institute of Diabetes and 

Digestive and Kidney Diseases conducts and 

supports many basic and clinical research 

studies on IBS, including epidemiological 

studies examining its possible genetic and 

environmental causes. 

Participants in clinical trials can play a more 

active role in their own health care, gain 

access to new research treatments before 

they are widely available, and help others 

by contributing to medical research. For 

information about current studies, visit 

www.ClinicalTrials.gov. 

4 Irritable Bowel Syndrome (IBS) in Children 
For More Information 

International Foundation for Functional 

Gastrointestinal Disorders 

P.O. Box 170864 

Milwaukee, WI 53217–8076 

Phone: 1–888–964–2001 or 414–964–1799 

Fax: 414–964–7176 

Email: iffgd@iffgd.org 

Internet: www.iffgd.org 

North American Society for Pediatric 

Gastroenterology, Hepatology and Nutrition 

P.O. Box 6 

Flourtown, PA 19031 

Phone: 215–233–0808 

Fax: 215–233–3918 

Email: naspghan@naspghan.org 

Internet: www.naspghan.org 

You may also find additional information about this 

topic by 

• searching the NIDDK Reference Collection at 

www.catalog.niddk.nih.gov/resources 

• visiting MedlinePlus at www.medlineplus.gov 

This publication may contain information about medications. When prepared, this publication included 

the most current information available. For updates 

or for questions about any medications, contact 

the U.S. Food and Drug Administration toll-free at 

1–888–INFO–FDA (463–6332) or visit www.fda.gov. 

Consult your doctor for more information. 

The U.S. Government does not endorse or favor any 

specific commercial product or company. Trade, 

proprietary, or company names appearing in this 

document are used only because they are considered 

necessary in the context of the information provided. 

If a product is not mentioned, the omission does not 

mean or imply that the product is unsatisfactory. 

5 Irritable Bowel Syndrome (IBS) in Children 
National Digestive Diseases 

Information Clearinghouse 

2 Information Way
 

Bethesda, MD 20892–3570
 

Phone: 1–800–891–5389
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: nddic@info.niddk.nih.gov
 

Internet: www.digestive.niddk.nih.gov
 

The National Digestive Diseases Information 

Clearinghouse (NDDIC) is a service of the 

National Institute of Diabetes and Digestive 

and Kidney Diseases (NIDDK). The NIDDK 

is part of the National Institutes of Health of 

the U.S. Department of Health and Human 

Services. Established in 1980, the Clearinghouse 

provides information about digestive diseases 

to people with digestive disorders and to their 

families, health care professionals, and the 

public. The NDDIC answers inquiries, develops 

and distributes publications, and works closely 

with professional and patient organizations and 

Government agencies to coordinate resources 

about digestive diseases. 

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists 

and outside experts. This publication was 

reviewed by Jeffrey S. Hyams, M.D., Connecticut 

Children’s Medical Center. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this fact sheet to duplicate and 

distribute as many copies as desired. 

This fact sheet is also available at 

www.digestive.niddk.nih.gov. 

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 09–4640 

November 2008