Irritable Bowel Syndrome | Diagnosis & Treatment

How is irritable bowel syndrome diagnosed?

There is no definitive test to diagnose irritable bowel syndrome (IBS). A clinician will perform a physical exam and take a full medical history to screen the child for a condition with similar symptoms, such as celiac disease or inflammatory bowel disease (IBD). The clinician may ask about family history, recent infections, stress and medications the child is taking. They may also ask about the child's diet and any signs of food sensitivities.

Other tests may include:

  • blood test
  • stool test
  • urine analysis
  • lactose breath hydrogen test
  • abdominal X-ray
  • abdominal ultrasound
  • colonoscopy

If a child is growing normally, has no signs of another gastrointestinal (GI) disorder and has had symptoms for two months or more, they may be diagnosed with IBS.

How is IBS treated?

IBS is a manageable condition and the goal of treatment is to reduce symptoms so the child can resume daily activities. Depending on the results of the health history and diagnostic tests, treatment may include:

  • dietary changes
  • talk therapy, biofeedback or acupuncture
  • medication

IBS Dietary changes

If child has IBS with constipation, foods high in fiber like fruit, vegetables and whole-grain bread can make it easier to pass stool. However, fiber can also increase gas so it is important to add fiber to a child’s diet a little at a time to give the child’s stomach a chance to adapt.

If a child has IBS with diarrhea, high-fiber foods could make symptoms worse.

Other foods that a child may need to avoid, depending on the type of IBS they have:

  • caffeine, including coffee and many soft drinks that can have a laxative effect, making diarrhea worse
  • artificial sweeteners like sorbitol, mannitol, xylitol and maltitol that can have a laxative effect
  • foods like beans and cabbage that produce gassiness
  • milk and other dairy products if the child is lactose intolerant

Talk therapy

The goal of talk therapy is to help the child and family to understand the symptoms, what triggers them and how to manage the triggers. Talk therapy can include a combination of the following techniques:

  • cognitive behavioral therapy helps the child identify and control thought patterns that may make IBS symptoms worse
  • relaxation training involves learning how to decrease muscle tension that can exacerbate IBS
  • biofeedback provides the child feedback about how their body works so they can learn to recognize IBS symptoms and how to control them

Medications for IBS

Many children with IBS can be treated effectively with dietary changes and talk therapy alone. However, if IBS symptoms are severe or persist despite other treatments, the clinician may recommend medication. The type of medication will depend on the child’s symptoms.