Spastic colon is a condition that doctors now refer to as irritable bowel syndrome, or IBS. According to Mayo Clinic gastroenterologist Michael Picco, M.D., IBS can affect anyone, including children. IBS, like other gastrointestinal problems, tends to follow a familial pattern, so it's not uncommon for children with IBS to come from families where other relatives also have the disorder.
Cause
According to Dr. Chung Owyang, chief of gastroenterology at the University of Michigan Health System and author of the 2008 chapter on IBS in "Harrison's Principles of Internal Medicine," IBS results from overactive nerve endings in the gastrointestinal tract and especially the colon. Children frequently develop the disorder during times of stress at school or home.
Clinical Features
Children with irritable bowel syndrome typically describe recurrent episodes of cramping abdominal pain or discomfort accompanied by constipation or diarrhea. In some cases, children also report nausea, loss of appetite, passing white mucous with their stools, increased gas, an urgent need to defecate, a sensation of incomplete defecation or pain in the rectum.
Associated Symptoms
Children with IBS may complain of non-gastrointestinal symptoms such as backaches, headaches, anxiety, depression, fatigue and difficulty concentrating. In adults with IBS, conditions such as migraine headaches, fibromyalgia, major depressive disorder, generalized anxiety disorder and other pain- and stress-related conditions occur more often in IBS patients than the general population.
Diagnosis
According to the American Academy of Pediatrics, IBS in children is diagnosed on the basis of medical history and physical examination, plus one or more of the following tests: urinalysis, urine culture, complete blood count, erythrocyte sedimentation rate and fecal occult blood. In rare cases, children may need to undergo diagnostic procedures that examine the colon, such as sigmoidoscopy or colonoscopy.
Diet Change
Parents and caregivers should gradually increase the child's fiber intake by increasing servings of whole grain breads and cereals, legumes, fruits and vegetables. Reducing or eliminating fatty foods, dairy products, chocolate, caffeine, fruit juices and foods sweetened with high-fructose corn syrup can also help. A pediatrician or family doctor may also recommend keeping a food diary or consulting with a registered dietitian.
Behavioral Management
Parents and caregivers can help children to manage stress by encouraging them to talk about what bothers them and helping them find an outlet for stress through exercise or pleasurable activities such as hobbies. Gastroenterologist Picco also recommends scheduling time each day for bowel movements.
Medications
According to Picco, doctors usually don't resort to medications to treat IBS in children. When they do, common choices include antispasmodics, antidiarrheals, antidepressants, laxatives and supplementary digestive enzymes.
References
- MayoClinic.com: IBS in Children: Is it Possible?
- American Academy of Pediatrics: Irritable Bowel Syndrome and Inflammatory Bowel Disease
- MayoClinic.com: What Is Spastic Colon?
- "Harrison's Principles of Internal Medicine, 19th edition;" A.S. Fauci et al. (eds); 2008
