It’s normal for kids to get stomach aches, but some kids have bad stomach pain all the time. If your child has abdominal pain, cramping, gas, bloating, diarrhea or constipation, you may be wondering if your child has IBD or IBS (inflammatory bowel disease or irritable bowel syndrome). But do you know the difference?
While many of the symptoms are similar, IBD and IBS are very different. IBS can cause pain, but there is no inflammation of the intestine and it doesn’t lead to serious disease, as with IBD. Understanding the differences between IBD and IBS can help parents know when to seek care and what to expect during diagnosis and treatment.
“It’s important to not diagnose either of these conditions yourself. If your child has these symptoms, you should take your child to a pediatrician, who can then refer your child to a pediatric gastroenterologist, if necessary” says Dr. Kenneth Grant, pediatric gastroenterologist at CHOC.
Pediatric Inflammatory Bowel Disease
IBD is a chronic condition caused by inflammation in the digestive tract. There are two main types of IBD – ulcerative colitis and Crohn’s disease. Ulcerative colitis affects the colon, and Crohn’s disease can affect any part of the digestive system.
“No one knows for sure that causes IBD or why it appears when it does. We do know that people who have family members with IBD are more likely to develop the disease. There is evidence that patients with this disease have abnormal activity of the immune system. Diet, nutrition and the environment may all play key roles,” says Dr. Grant. IBD is considered an autoimmune-related condition, meaning the body’s immune system mistakenly attacks the lining of the digestive tract. This ongoing inflammation can damage the intestinal walls and interfere with the body’s ability to absorb nutrients. Because of this, children with IBD may also experience delayed growth or delayed puberty if the disease is not treated.
IBD is diagnosed by a pediatric gastroenterologist through complete medical history, physical examination and specialized diagnostic procedures, such as blood tests, stool tests, endoscopy, colonoscopy or radiology exams. IBD treatment usually consists of medication therapy or surgery with the goal of reducing inflammation.
During diagnosis, doctors may also check for signs of inflammation in the blood, anemia, or nutritional deficiencies. Imaging tests such as MRI or CT scans may be used to look closely at the intestines. These tests help physicians determine the type of IBD and how severe it may be.
Treatment for pediatric IBD often includes anti-inflammatory medications, immune-modulating drugs, or biologic therapies that target the immune system. Some children may also require nutritional therapy or special diets to support healing and growth. In severe cases, surgery may be needed to remove damaged sections of the digestive tract. Although IBD is less common than IBS, it is a serious medical condition that requires ongoing care from a pediatric gastroenterologist. With proper treatment, however, many children are able to manage symptoms effectively and live healthy, active lives.
Symptoms of IBD
- Abdominal pain
- Diarrhea, sometimes bloody
- Urgency to stool
- Fatigue
- Weight loss
- Loss of appetite
- Rectal bleeding
- Fever
- Growth failure
- Rash
- Joint pain
Parents should contact a pediatrician promptly if their child experiences symptoms such as persistent diarrhea, blood in the stool, unexplained weight loss, or ongoing fatigue. These may be warning signs of inflammatory bowel disease and should be evaluated by a healthcare professional.
Pediatric Irritable Bowel Syndrome
IBS is not a disease, but rather, a collection of symptoms. There is no damage or inflammation in the digestive system. When abdominal pain is accompanied with changes in bowel movement habits, either constipation or diarrhea, this is called irritable bowel syndrome.
Although the exact cause is not known, nerve signals or chemicals secreted by the gut or brain may cause the gut to be more sensitive to triggers that normally do not cause significant pain (such as stretching or gas bloating). The nerve dysfunction also results in change in bowel motility leading to constipation or diarrhea. In school-age children and teenagers, symptoms may flare during stressful times, such as exams, travel, or changes in routine. Certain foods may also trigger symptoms in some children.
To diagnose IBS, a physician should rule out a diagnosis of IBD. Doctors typically begin with a detailed medical history and physical exam. If symptoms suggest IBS and there are no “red flag” symptoms such as blood in the stool or unexplained weight loss, extensive testing may not be necessary. Instead, the pediatrician may focus on symptom patterns and lifestyle factors.Treatment often includes simple strategies such as increasing dietary fiber, avoiding foods that trigger symptoms, drinking enough water, and maintaining regular meals. Some children benefit from probiotics or medications that help regulate bowel movements. Stress-management techniques, counseling, or behavioral therapy may also help children whose symptoms are triggered by anxiety or stress.
Symptoms of IBS
- Abdominal pain
- Bloating
- Nausea
- Heartburn
- Chronic or intermittent diarrhea
- Chronic or intermittent constipation
- Urgency to pass a bowel movement or sensation of incomplete passage of bowel movement
- Passage of mucus in the stool
Unlike IBD, children with IBS usually do not experience fever, blood in the stool, or growth problems and their symptoms may come and go over time.
When To See A Pediatrician
If your child has stomach pain that occurs frequently, wakes them at night, interferes with school or activities, or is accompanied by concerning symptoms such as vomiting, blood in the stool, persistent diarrhea, or weight loss, it’s important to schedule an appointment with a pediatrician.
To make an appointment with a CHOC gastroenterology specialist, call 888-770-2462.
