Irritable Bowel Syndrome
Approximately 10-15% of school age children and adolescents have symptoms of IBS which interfere with their daily life. IBS is more common in girls than boys and it tends to run in families. This guide was created to answer your questions about IBS and give you ways to make dietary changes that can help lower your symptoms.
What is Irritable Bowel Syndrome (IBS)?
Irritable bowel syndrome is a condition that involves the muscles in the intestines. Normally these muscles tighten and release in a regular pattern to move waste through the intestines. However with IBS the contractions may be too fast (causing diarrhea) or too slow (causing constipation). That’s why it is called “irritable” bowel syndrome.
Symptoms may include:
- Stomach pain
- Constipation
- Loose stools
- Both constipation & loose stools
- Bloating
- Gas
- Mucus in the stool
What causes IBS?
IBS is thought to be caused by:
- Movement in the digestive tract that is not typical
- Extra sensitive organs in the abdominal cavity
- Feelings of anxiety (or nervousness), stress, and anger
- A germ or infection
How is IBS diagnosed?
IBS is diagnosed by a health care provider based on a person’s symptoms, their medical history, physical exam, blood work, and sometimes with the help of other diagnostic tests. Tests and minor procedures may be done to make sure the symptoms are not due to another medical problem.
Tests may include:
- Blood test- to check for infection
- Urine culture- to check for a urinary tract infection
- Stool sample- to check for parasite infections and hidden blood
- Lactose breath hydrogen test- to find out if you have trouble digesting milk products
- Abdominal x-ray- to check internal organs
- Abdominal ultrasound- to check internal organs using sound ways
- Endoscopy- this is rarely done to look at the inside of part of the digestive tract
How is IBS treated?
The goal of the treatment is to decrease inflammation and to make the digestive process more normal. Treatment is started only after the diagnosis is made by a health care provider and can vary based on age, overall health, medical history, and how bad the symptoms are.
Ways to manage IBS include:
- Meeting with a Registered Dietitian
- Limiting milk and milk products (if you are lactose intolerant)
- Finding positive ways to deal with stress
- Complementary therapies such as biofeedback and acupuncture
- Medicine (if necessary)
How can I find out if the foods I am eating are causing me to have IBS symptoms or making my IBS symptoms worse?
If you think that your IBS symptoms are related to the foods you are eating, the best way to find out more is to work with a Registered Dietitian. You can get a better idea if the foods you are eating are affecting your symptoms by writing down the foods that you eat and the symptoms that you have in a “food diary” (see sample below).
When keeping a food diary, try to pay attention to the following things:
- Foods that do not cause symptoms within 3 days of eating them and at least 3 times after eating them are probably not the cause of your symptoms.
- If you find a food that you think causes IBS symptoms most of the time, try to stop eating it for at least 2 weeks, and then add it back in slowly to see if you notice a change in your symptoms.
- If there are foods that you know are causing symptoms, take them out of your diet for 3-6 months and then try going back to what you were eating before to see if symptoms come back or are worse.
| Sample Food Diary | |||
| Meal |
Food & Drink | Symptoms | Supplements |
| Breakfast | Cheerios®, milk, banana, eggs | Gas, bloating | Vitamin D |
| Snack | Applesauce | ||
| Lunch | Macaroni & Cheese | Gas, bloating, diarrhea | |
| Snack | Apple | ||
| Dinner | Chicken, rice, carrots | ||
Download a blank food diary sheet here. Make a copy for each day, and track what you ate and whether or not you felt any symptoms.
What has been helpful to others with IBS?
In general, people react to foods differently but many people with IBS find that certain things tend to bring on symptoms or make them worse.
Try avoiding or limiting:
- Large meals (eat smaller more frequent meals instead)
- Dairy foods and foods that contain lactose
- Artificial sweeteners like sorbitol, mannitol, xylitol which are mainly found in sugarless gum and candy
- High fructose corn syrup sources such as candy, sweetened cereals, and soda as well as other sources which can be found by checking the ingredients section of food labels
- Foods that are gas-producing (beans, peas, broccoli, cabbage, and bran)
- Foods high in insoluble fiber (wheat bran, corn bran, and ground flax seed)
Try adding:
Some people have found that increasing their intake of foods or supplements that are high in soluble fiber by 10-20 g/day can be helpful with symptoms. In comparison to insoluble fiber which adds bulk to the stool and speeds up digestion, soluble fiber turns into a gel and slows down digestion. Soluble fiber supplements include Ispaghula and psyllium. Foods that are good sources of soluble fiber include oats, oat bran, legumes, and barley. Check the chart below for sources of soluble fiber.
| Food Source |
Soluble Fiber (g) | Total Fiber (g) |
| Cereal Grains (½ cup cooked) | ||
| Barley | 1 | 4 |
| Oatmeal | 1 | 2 |
| Oatbran | 1 | 3 |
| Seeds | ||
| Psyllium seeds, ground (1 Tbsp) | 5 | 6 |
| Fruit (1 medium fruit) | ||
| Apple | 1 | 4 |
| Banana | 1 | 3 |
| Blackberries (½ cup) | 1 | 4 |
| Citrus Fruit (orange, grapefruit) | 2 | 2-3 |
| Nectarines | 1 | 2 |
| Peaches | 1 | 2 |
| Pears | 2 | 4 |
| Plums | 1 | 1½ |
| Prunes (¼ cup) | 1.5 | 3 |
| Legumes (½ cup cooked) | ||
| Black Beans | 2 | 5½ |
| Kidney Beans | 3 | 6 |
| Lima Beans | 3½ | 6½ |
| Navy Beans | 2 | 6 |
| Northern Beans | 1½ | 5½ |
| Pinto Beans | 2 | 7 |
| Lentils (yellow, green, orange) |
1 | 8 |
| Chick Peas | 1 | 6 |
| Black eyed Peas | 1 | 5½ |
| Vegetables (½ cup cooked) | ||
| Broccoli | 1 | 1½ |
| Brussels Sprouts | 3 | 4½ |
| Carrots | 1 | 2½ |
| Source | ||
Is IBS the same as inflammatory bowel disease (IBD)?
No. IBD is an ongoing disease that is caused by the immune system fighting the colon. It includes two different diseases, ulcerative colitis and Crohn’s disease.
Signs that you might have IBD include:
- Bloody diarrhea for more then 2 weeks
- Abdominal pains (in your stomach) that last a long time
- Fevers for no reason
- Joint swelling
- Poor growth
- Anal infections
IBS is different than IBD, because in IBS the intestine is not inflamed and it almost never causes rectal bleeding.
What other ways can IBS or IBD affect me?
Irregular bowel habits can be frustrating and lead to emotional stress. Luckily there are healthy ways to lower your stress level, such as taking a walk or talking with a friend. Here are some additional ideas.
Stomach problems such as cramping, constipation, and loose stools can be very uncomfortable. If you are having some or all of these symptoms a lot of the time, you may have irritable bowel syndrome (IBS). Make an appointment with your health care provider and a Registered Dietician who will help you make changes in your diet that can improve, or even get rid of some of your IBS symptoms.
Updated: 3/2/2010
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