Child holding tummy

Are tummy aches a sign of IBS? How to find out

If your child complains of ongoing tummy aches and has constipation or diarrhea, you might wonder what the cause is and how serious it is.

Irritable bowel syndrome—or IBS—could be the culprit. And parents should take it seriously.

Just as in adults, IBS symptoms for children include repeated pain in your abdomen and changes in your bowel movements that could cause diarrhea or constipation—or both. What’s tricky for parents is that your child could have these without any visible signs.

“We call it functional abdominal pain,” said Dr. Annie Goodwin, a pediatric gastroenterologist at UTMB Health. It's functional because there's no source of inflammation or infection or blockage that's causing these symptoms.”

That doesn’t mean that the pain isn't real.

“These kids are really feeling the pain,” Dr. Goodwin said. “They're really uncomfortable. It has more to do with what's called the gut-brain access. Our bodies have millions of nerves that function in our GI tract, and they help the GI tract do its normal functions like move things along and absorb nutrients.”

In some kids and some adults, it's not that these nerves are hypersensitive, so things that shouldn't cause them pain or discomfort causes them abnormal amounts of pain. Different causes can trigger this hypersensitivity.

“Sometimes kids can develop it after an infection, whether it's a viral infection or a bacterial infection,” Dr. Goodwin said. “Sometimes it's stress related. These nerves are connected to our brain. When we feel nervous, we feel the butterflies. Having butterflies is actual discomfort and pain you feel in your stomach.”

Children can have different symptoms for it, though. Most often, she sees children who have abdominal pain that comes and goes.

“Sometimes it's worse on school days,” Dr. Goodwin said. “Sometimes parents can actually correlate what triggers their pain if it's associated with different changes in their bowel movements. If they have pain and also have diarrhea and pain and constipation, then it falls under IBS, irritable bowel syndrome.”

Certain foods can also trigger IBS.

“One thing I recommend that all kids try is to eliminate milk and lactose from their diet initially because that can be a common trigger,” Dr. Goodwin said. “Keep a food diary so you can see whether or not there's a pattern to certain foods that they eat and the triggers that they have.”

One specific diet that researchers suggest for IBS or functional abdominal pain is called a low FODMAP diet—FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols.

“It's essentially a diet that's low in complex sugars,” Dr. Goodwin said.

One thought is that these sugars are a little bit harder for our GI tracts to absorb. The bacteria in your intestines can digest these sugars instead and produce gas—and pain.

The FODMAP diet itself consists of two phases. The first phase involves eliminating foods that are high in FODMAPs to see if that provides any symptomatic relief. The second phase involves a slow re-introduction of foods that are high in FODMAPs so that at the end, you can pinpoint some specific food triggers. This diet is usually done under the guidance of a GI doctor and a dietitian who is knowledgeable about the diet.

“If you feel like it helps, I think it's worth pursuing as long as we're able to maintain a well-balanced diet, and it doesn't affect their growth and development,” Dr. Goodwin said. “That's the big thing we care about in pediatrics: we want to make sure they get the calories and all the nutrients that they need to continue growing and developing.”

Learn more and find resources on IBS and other digestive health concerns