Because there is no cure for irritable bowel syndrome (IBS), treatment consists of controlling its symptoms. For most children with IBS, this can be accomplished through diet and stress management. In addition, children may be instructed to make sure they have regular bowel movements each day.

The first step in changing a child’s diet is to identify which foods or activities appear to trigger or aggravate the symptoms of IBS. It may be helpful to keep a food diary or log that details the foods eaten each day, the type of symptoms experienced and the times the symptoms occur. Treatment of IBS symptoms typically involves avoiding foods (such as fats) or behaviors that aggravate symptoms.

In contrast, some foods – particularly those high in fiber – can often help to keep a child’s colon functioning properly. Fiber adds bulk to stool in the digestive tract, speeding digestion and helping to alleviate constipation. In addition, fiber keeps the colon mildly distended, which may help prevent muscle contractions (spasms) in children with IBS. It may also improve the consistency of stool, helping to alleviate diarrhea.

Fruits, vegetables and beans are good examples of high-fiber foods that can help fend off symptoms related to IBS. “Fun” foods such as popcorn can also help prevent IBS symptoms. It is important to note that most fiber-rich foods contain both soluble fiber (which dissolves in liquid) and insoluble fiber (which does not dissolve in liquid). Soluble fiber can help relieve both diarrhea and constipation. Insoluble fiber can moderate digestion and alleviate diarrhea. However, the amounts of these types of fiber differ from food to food.

Some experts warn against diets for children that are too high in fiber. Too much fiber may aggravate or cause diarrhea, and may cause flatulence and abdominal distention. Parents and caregivers should consult their child’s pediatrician about choosing the right fiber-rich foods for their child’s diet.

Parents are also encouraged to urge their children to eat smaller meals at a slower pace. Eating large amounts of food in a single sitting should be avoided since it may cause cramping and diarrhea. Five or six smaller meals throughout the day may be easier to digest for children with IBS. In addition, eating meals too quickly can lead to the unintentional swallowing of air, causing gas and bloating and abdominal distension in children with IBS.

Drinking six to eight glasses of water a day is recommended for hydration, especially for children with diarrhea-predominant IBS. 

Children with IBS may be more sensitive to emotional stress or tension. Stress management is especially important to reduce or prevent the symptoms of IBS. The methods can include:

• Relaxation therapies. Treatments that involve techniques such as controlled breathing may help children to manage stress and other emotional triggers of IBS.
  
  
• Counseling. Parents and caregivers are urged to talk to their children about feelings of stress related to problems in the home, difficulties at school or problems with friends. In cases of severe stress or emotional difficulty, children may benefit from consultation with a mental health professional.
  
  
• Regular exercise and sleep. Encouraging children to exercise can help keep the digestive tract functioning normally. This is especially helpful for children with constipation-predominant IBS. In addition, children who get adequate amounts of rest and sleep may feel less stress, which can help facilitate digestion.

A variety of medications are available to treat the symptoms of IBS in adults. In some cases, these medications may be prescribed to children. For example, tricyclic antidepressants may be prescribed to control a child’s pain and anticholinergics may be prescribed to control intestinal cramping. Some medications that are used to treat IBS in adults have not been tested for safety in children and are not used in the treatment of children.

Use of medications is less common in treating IBS in children than in adults because children are at greater risk of the body becoming dependent on certain medications (e.g., laxatives) to function normally. When medications are prescribed, it is usually because a child’s symptoms do not respond to dietary changes and/or stress management. Parents are urged to ensure that their child takes these medications exactly as prescribed to avoid any potential problems.