Abdominal pain, stool changes, flatulence are symptoms that may indicate irritable bowel syndrome (IBS) in children. This is a multifunctional disorder, in which, for at least 12 weeks, the patient is disturbed by abdominal pains that are significantly lowering or passing after defecation, accompanied by a change in stool frequency and fecal structure.
Causes
This is a disease of the gastrointestinal system, characterized by the presence of abdominal pain, which decreases significantly with bowel movements. The main factors contributing to the onset of the disease are still not fully understood. The reasons why there is irritable bowel syndrome in children are many:
- hereditary predisposition to the development of the disease;
- dysbiosis;
- rotavirus infections;
- unbalanced diet;
- helminthic infestations;
- intestinal infections;
- the presence of an unfavorable psycho-emotional climate in the family;
- visceral hypersensitivity;
- stagnation of food in the walls of the intestine;
- binge eating;
- insufficient fiber intake;
- the presence of brain damage during labor;
- lack of breastfeeding;
- the use of antibiotics;
- anatomical and physiological structural features of the abdominal system.
The danger of this disorder is the development of mental and emotional disorders in the child, and sometimes the stress itself provokes the appearance of functional diseases of the gastrointestinal system.
Symptoms
The clinical symptoms of the disease are distinguished by their diversity and the rate of development of clinical manifestations. The disorder is characterized by the absence of complications even if a certain therapeutic effect is not received. Symptoms of the syndrome increase with the urge to empty the intestines, after the end of bowel movement, all symptoms disappear. The main symptoms of irritable bowel syndrome in children:
- Pain in the abdomen. It is temporary and occurs when bowel movements are necessary.
- Violation of the act of defecation. There are three times more frequent stools, as well as the presence of incomplete emptying. Some patients have constipation. Disorders of the stool and an increase in the intensity of going to the toilet can also occur.
- Flatulence. Stagnation of food and its accumulation in the anatomical cavity of the intestine causes an increase in gas formation. Symptoms of this disorder appear in bloating and a feeling of discomfort and heaviness.
- Chronic fatigue syndrome.
- Dizziness.
- Paresthesia. They are one of the types of sensitivity disorders, characterized by the spontaneity of the appearance of a burning sensation or a feeling of goosebumps. This reaction appears when a child feels the need for emptying. Such a reaction indicates the occurrence of psychological discomfort and fear.
- Increased frequency of urination.
- Migraine.
- The appearance of behavioral and psychoemotional disorders.
- Mucous discharge and a change in the consistency of feces. Often observed in infants who are fed not with breast milk, but with mixtures. Excessive secretion of mucus helps to facilitate the act of emptying.
- The appearance of false desires.
- Colic. Painful and acute pains are localized in the abdomen. As a rule, the appearance of this symptom indicates an unbalanced diet and the lack of systematization. It is also necessary to ensure sufficient consumption of drinking water to speed up digestion and reduce the intensity of colic.
If a manifestation of any signs of the disease is detected, you should visit a medical institution to conduct a detailed differential diagnosis of the condition of the child. The examination of the baby must be carried out by a gastroenterologist with the availability of appropriate patents for medical practice.
How to diagnose and treat IBS in children?
The identification of the disease is the main task of diagnosis. The study excludes organic changes in the intestine, tumor-like changes, inflammatory processes, infections, and the presence of parasites. All complaints of the child are thoroughly analyzed, heredity, previous illnesses are evaluated. It should be noted that the diagnosis can finally be made according to the characteristic symptoms, which persists after three months.
Necessary Activities
The list of necessary diagnostic measures should include the following:
- as a basis for a detailed diagnosis, a sampling of blood tests is necessary (general clinical and biochemistry);
- analysis of feces is necessary to confirm or exclude the presence of dysbiosis, occult blood in the feces, helminths;
- ultrasound examination of the abdominal cavity and colon sonography;
- endoscopic examination (colonoscopy, sigmoidoscopy, FGDS) will allow you to examine the condition of the intestinal walls, detect visual pathological changes, and also, if necessary, take a sampling of the material for a biopsy;
- fluoroscopy can provide information about chronic diseases of the gastrointestinal tract;
- manometry of the anorectal intestine is necessary to evaluate intestinal motor function.
If any pathologies are detected, the examined child needs additional consultation of narrow children's specialists, such as:
- proctologist;
- gastroenterologist;
- neurologist;
- psychiatrist.
Thus, the diagnosis using the above methods is to exclude pathological changes and other diagnoses.
Drug treatment
Drug treatment of irritable bowel syndrome in a child of 6 years (or any other age) is aimed at suppressing unpleasant manifestations, which are extremely diverse. For this reason, treatment includes various categories of substances. Their use should proceed under the strict supervision of the attending doctor.
Dietary supplements and herbs
To cure the disease, numerous herbs are used that have a pharmaceutical effect, as well as drugs that are made on their basis. They can help with increased gas formation, reduce abdominal pain, remove inflammation in the intestinal tract, and are used for constipation and diarrhea. This also includes dietary supplements with the entry of probiotics, such as Narine, Bifiform, etc. But there is no evidence that their use is effective in this pathology.
Antispasmodic substances
For inflammatory bowel syndrome, doctors strongly recommend that you pay attention to the following drugs. They stop the pain and relieve some of the symptoms:
- No-Shpa;
- Buscopan
- "Dicetel";
- Duspatalin
- Niaspam and others.
These medications minimize pain by removing spasms of the intestinal tract. The structure of most of them includes peppermint oil, which occasionally causes a burning sensation on the skin or heartburn. Medications are prohibited for use during pregnancy.
Gastrointestinal functioning regulation
Pharmaceutical preparations that normalize the functioning of the gastrointestinal tract are prescribed depending on the type of IBS. To cure irritable bowel syndrome with constipation, the doctor prescribes laxatives. They increase the amount of fluid in the feces, making it softer. During the intake should consume a huge amount of water. Negative effects are likely, such as bloating or flatulence.
Prodivodiarrheal substances, Imodium and Loperamide, help to improve the patient’s condition with irritable bowel syndrome with diarrhea. They compact the excrement masses, allowing them to reach the required size and increase the passage time through the digestive tract. In most cases, patients notice a favorable result, but abdominal cramps, bloating and lethargy are not excluded. Contraindications are similar to those of laxatives.
Antidepressants
This category of medication changes the psycho-emotional state of the patient. In the event that there is diarrhea and abdominal pain without signs of deep depression, the doctor prescribes medications from the category of tricyclic antidepressants:
- Amitriptyline;
- Imipramine.
As a secondary result, lethargy and dry mouth occur, but after 10 days of administration they disappear. In irritable bowel syndrome with constipation, manifested by depression and abdominal pain, selective inhibitors of the opposite uptake of serotonin - “Fluoxetine” and “Citalopram” are used. But in case the patient has diarrhea, the situation will only worsen. Probably a temporary decrease in visual acuity and dizziness. Regardless of the type of antidepressant, it is necessary to use them, strictly adhering to the dose and interval of administration.
Psychotherapy
Many are interested in how to treat irritable bowel syndrome in children. Clinical recommendations are discussed above, but you can use another way - psychotherapy. The best result is cognitive-behavioral treatment. There are several goals for psychotherapeutic work with the patient.
The first goal is to eliminate the fear of waiting for the next seizures and change the "avoiding" behavior. Here, the period of studying self-control is very significant when an exacerbation begins, methods are used that help to reduce the degree of tension and fear. These are specialized concentration and breathing procedures. Improving self-control makes it possible to more regulate behavior, increase the comfort zone when moving in your own life. And as a result, reflexes of the intestinal tract, reclining in the mechanism of IBS reinforcement, are weakened.
In addition, attention is paid to the development of personality traits, because similar states are characteristic of emotionally unstable and restless individuals who have "learned" to limit their stress within the body. Research is being conducted and the mental processing of the current pressing problems, past disasters in life, the expectation of impending failures and the impending meaninglessness of existence. This kind of systematic approach to the question, if a person suffers from irritable bowel syndrome, makes it possible to cope more reliably and with a stable result for the future.
Diet
Consuming large amounts of food can cause stomach cramps and diarrhea, so you need to eat in small portions or eat less, but increase the number of meals. Also, during meals, it is necessary to ensure that the child is not in a hurry and carefully chews food. First of all, you need to give preference to fiber products. Fiber has a number of useful properties: relieves spasms, improves digestion and makes the baby's stool softer, which facilitates the work of the intestines. With irritable bowel syndrome in children, Komarovsky, a well-known doctor, also recommends turning to a diet.
There are two types of fiber:
- Soluble fiber - beans, fruits, oatmeal.
- Insoluble fiber - whole grains and vegetables.
Studies show that soluble fiber is more effective in relieving symptoms of IBS. To determine the right amount of fiber for a child per day, nutritionist recommends using the rule "age plus 5 grams".
For example, a seven-year-old child should receive 7 plus 5, that is, twelve grams of fiber per day. In some cases, fiber can cause increased gas formation and exacerbate the symptoms of IBS, so fiber per day may vary for different children.
You should also avoid foods that include gluten protein. Gluten-containing foods include most cereals, grains, and pasta.
More and more often, doctors are advising to try a special diet, known as FODMAP. This diet allows you to reduce the consumption of foods containing difficult to digest carbohydrates. FODMAP carbohydrates are poorly and not completely absorbed in the intestines and cause an upset.
These products include:
- apples, apricots, blackberries, cherries, mangoes, nectarines, pears, plums and watermelon, or juice containing any of these fruits and berries;
- canned fruits and dried fruits;
- asparagus, beans, cabbage, cauliflower, garlic, lentils, mushrooms, onions, peas;
- milk, cheese, yogurt, ice cream, cottage cheese and other dairy products;
- wheat and rye products;
- high fructose honey and foods;
- sweets, chewing gum and everything else created using artificial sweeteners.
These principles of diets have conflicting points, so it is important to remember that each child has his own individual characteristics. Therefore, it is important to seek help from a medical facility.
It is recommended that you keep a food journal with a list of meals to keep track of which foods cause symptoms of IBS in your child. Using this method, you can make an individual diet.