Everyone gets a stomachache or a bout of diarrhea now and then. But for some people stomachaches are a regular occurrence. If you're one of these people and you often feel bloated, have gas-like pains that are relieved when you go to the bathroom, or if you're sometimes constipated and then just as quickly find yourself coping with diarrhea, you may have an intestinal disorder called irritable bowel syndrome.
What Is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a somewhat baffling yet common intestinal disorder that affects the colon (the large intestine). The colon's main function is to absorb water and nutrients from partially digested food. Anything that is not absorbed is slowly moved through the colon toward the rectum and out of the body as waste in the form of feces (also called stool).
Muscles in the colon work to get rid of the body's waste products by contracting and relaxing as they push the undigested food through the large intestine. These muscles must also work together with other muscles in the body to push the waste out of the anus. If the muscles in the colon don't work at the right speed for proper digestion or if the coordination with muscles in the rectum or pelvis is somehow interrupted, the contents of the colon are not able to move along smoothly. When this happens, a person can feel the abdominal cramps, bloating, constipation, and diarrhea that may be signs of IBS.
A lot of teens have IBS — it's estimated that between 6% and 14% of all adolescents have symptoms of IBS, which appears to affect more girls than guys. The good news is that although IBS can be uncomfortable, embarrassing, and even downright painful for some people, it's not life threatening. And, unlike other digestive conditions, such as inflammatory bowel disease, IBS doesn't carry a risk of permanent damage to the intestines.
What Are the Symptoms of IBS?
The symptoms of IBS are usually recurring (meaning that a person will have bouts of symptoms on an ongoing basis rather than just once or twice a year). People with IBS often notice their symptoms flare up at certain times — for some people it's whenever they eat a large meal, for others it may be when they're under a lot of pressure or stress. Some girls notice that they get symptoms of IBS around the time of their periods.
The primary symptom of IBS is pain or discomfort (bloating, etc.) in the abdomen. Of course, if you have a stomachache, gas, or bloating once in a while, it doesn't mean you have IBS. People with IBS have at least two of the following symptoms:
- pain or discomfort that is relieved when a person goes to the bathroom and has a bowel movement
- pain or discomfort that is accompanied by changes in a person's regular bowel movement patterns (for example, the person goes to the bathroom more frequently or less often)
- pain or discomfort that is accompanied by changes in the way a person's stool (poop) normally looks. Some people become constipated and their stools become hard (and difficult to pass); other people develop diarrhea.
Someone who has only one of these symptoms probably doesn't have IBS.
Because IBS is a problem with the colon, and the colon removes water from unprocessed food waste, it's common for people with the condition to be constipated or have diarrhea. Constipation occurs when waste matter remains in a person's colon for too long so that too much water is absorbed, making the stool unusually hard and difficult to pass. If the muscles in the colon move the contents along too fast, though, the colon doesn't have a chance to remove enough fluid, so the person gets diarrhea.
Why Do Teens Get IBS?
No one knows exactly what causes IBS, although it tends to run in families.
A prior infectious illness (such as gastroenteritis) may increase a person’s risk of developing IBS. Exposure to a bacterial or viral infection can cause inflammation that can alter function of the gastrointestinal system.
Stress can also play a part in IBS. Stress can accelerate your colon and slow your stomach. Stressful feelings also can be a trigger for IBS — a problem because growing up, going to school, and being a teen aren't exactly stress-free experiences.
Foods can also be a trigger, but this is hard to predict. For example, a high-fat diet may bother some, while an extremely low-fat diet may cause diarrhea in others. Eating big meals and spicy foods often cause problems, as do caffeinated drinks (coffee or soda), alcohol, milk and milk products, and grains like wheat, barley, or rye. Some of these foods are linked to other digestive conditions like lactose intolerance or celiac disease, though, so it's important to see a doctor if you think a particular food is causing digestive problems.
Certain medications, like antibiotics, can trigger IBS symptoms in people who have the disorder.
What Do Doctors Do?
There is no specific test to diagnose IBS. Doctors usually diagnose the syndrome based on a physical exam and a patient's symptoms. For example, if a person has had abdominal pain for more than 12 weeks out of the previous year (not necessarily 12 weeks in a row), it's a sign to a doctor that IBS may be a possibility.
To diagnose the problem, a doctor will probably ask how often you have stomach or gas pain, whether you're ever constipated or have diarrhea, and if so, how long these problems last. He or she may ask questions about your bathroom habits, such as whether your bowel movements are regular, what your stools look like, and whether you ever feel like you need to have a bowel movement but then can't. It may feel embarrassing or even silly to answer these questions, but learning as much as possible about your symptoms will help the doctor diagnose what's going on.
In addition to doing a physical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called the medical history. You may need to ask a parent or other adult for some information.
Although there's no test for IBS, a doctor may send a patient for tests to make sure the symptoms aren't being caused by other problems.
How Is IBS Treated?
There's no cure for IBS. But there ways to take control of IBS symptoms. Here are some of the things that doctors recommend for people with IBS:
- Dietary changes. Some people with IBS find that careful eating helps reduce or eliminate IBS symptoms. You might try avoiding very large meals, drinks with caffeine, spicy or fatty foods, chocolate, some dairy products, and foods that contain gluten. Some people find that adding fiber — eating more fruits and vegetables, for instance — and drinking more water can help eliminate IBS symptoms, too.
Good eating habits can also be helpful in combating IBS. Eating regular meals, avoiding on-the-run eating, and paying attention to good nutrition can all be helpful.
- Lifestyle changes. If you have IBS that appears related to stress or the emotional roller coaster ride of being a teenager, you might want to review your lifestyle and make some changes. Consider ways to manage daily pressures, such as schoolwork, and make time for extracurricular activities you enjoy.
Be sure to get enough sleep and exercise — a sure-fire stress reducer. Your doctor might recommend some stress-reduction techniques, like breathing exercises. Preliminary research also shows that hypnotherapy may be helpful in managing IBS.
- Medications. For some people with severe IBS, doctors may suggest one of several prescription or over-the-counter medications. Depending on a person's symptoms, doctors may recommend over-the-counter laxatives (for constipation) or anti-diarrhea medications, or a doctor may prescribe muscle relaxers (for colon muscle spasm) or antidepressants (for anxiety and stress). Before trying any over-the-counter medicines, it's a good idea to talk to your doctor first to be sure you get the best one for you.
Your doctor will have suggestions on what might work for you. You can also keep a food diary so you can see if certain foods and events seem to trigger your IBS symptoms. Record what you eat, what symptoms you have, and when they occur.
What's Life Like for a Teenager With IBS?
Teens with IBS are just like everyone else! However, if you're living with IBS, you may feel wary of anything that could trigger symptoms — even otherwise fun events like playing in a championship game or going out for a fancy dinner before the prom. Learning more about the disorder and what triggers your own symptoms is the first step to taking action. You can then do what you need to take care of yourself, whether that's reducing stress by talking over problems with a school counselor or therapist, or watching out for spicy food when you're at the mall with friends.
Reviewed by: Devendra Mehta, MD, MBBS, MS, MRCP
Date reviewed: October 2007