Diagnosis of Irritable Bowel Syndrome in Children

How do doctors diagnose IBS in children?

To diagnose irritable bowel syndrome (IBS), doctors review a child’s symptoms and medical and family history and perform a physical exam. In some cases, doctors may order tests to rule out other health problems.

Review of a child’s symptoms

The doctor will ask about a child’s symptoms and look for a certain pattern in the symptoms to diagnose IBS.

The doctor may diagnose IBS if a child has pain in his or her abdomen at least 4 days each month along with one or more of the following symptoms

• pain related to bowel movements. For example, the pain may improve or get worse after bowel movements.
• a change in how often a child has a bowel movement.
• a change in the way a child’s stools look.

The doctor may diagnose IBS if

• the child has had symptoms for at least 2 months
• the child’s symptoms can’t be fully explained by another health problem

If a child has pain in the abdomen and constipation, the doctor may ask questions about how the pain is related to constipation. If abdominal pain goes away when the constipation goes away, the child may have a functional GI disorder called functional constipation instead of IBS.

The doctor will also ask about symptoms that could suggest a child has another health problem instead of IBS. These symptoms include

• arthritis
• bleeding from the rectum, bloody stools, or stools that are black and tarry
• disease in the tissues around the rectum
• nighttime diarrhea
• persistent pain in the upper or lower right side of the abdomen
• persistent vomiting
• problems or pain when swallowing
• unexplained fever
• weight loss, slowed growth, or delayed puberty

Medical and family history

The doctor will ask about the child’s

• diet and foods that may be related to symptoms
• history of emotional or mental health problems
• history of health problems other than IBS that could be causing the child’s symptoms
• medicines
• recent infections
• stressful events related to the start of symptoms

The doctor will also ask about the child’s family history of IBS and digestive diseases and disorders, such as celiac disease, inflammatory bowel disease, or peptic ulcer disease.

Physical exam

During a physical exam, a child’s doctor usually

• checks for lumps or swelling in the abdomen
• checks height and weight
• examines the child’s body for signs of health problems other than IBS
• listens to sounds in the abdomen using a stethoscope
• taps on the abdomen to check for tenderness or pain

What tests do doctors use to diagnose IBS in children?

The doctor may order blood tests, stool tests, and other tests to check for health problems other than IBS that could be causing a child’s symptoms.

Blood test

A health care professional will take a blood sample and send the sample to a lab. Doctors use blood tests to check for conditions other than IBS, including anemia, infection, and digestive diseases.

Stool test

The doctor will give the child or a caregiver a container for catching and holding a stool sample, along with instructions on where to send or take the kit for testing. Doctors use stool tests to check for blood in stool or other signs of infections or diseases. A doctor may also do a rectal exam, sometimes during the physical exam, to check for constipation, tenderness in the rectum, and other problems.

Other tests

The doctor may perform other tests to rule out health problems that cause symptoms similar to IBS symptoms. The doctor will decide whether the child needs other tests based on

• blood or stool test results
• a family history of digestive diseases
• symptoms that could be signs of another condition or disease

Other tests may include

• imaging tests such as abdominal ultrasound
• upper GI endoscopy with a biopsy to check for celiac disease or other problems in the upper GI tract
• colonoscopy to check for problems in the lower GI tract such as inflammatory bowel disease