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Ibs In Children

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jagw | 15:06 Mon 28th Oct 2013 | Body & Soul
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My daughter has suffered with constipation since she was about 2. She was given Lactulose for a while but this seemed to bloat her tummy and she'd often have tummy ache. About a year later she started having very painful 'rectal spasms'. This would wake her from her sleep and come on and off for up to an hour. It began to happen more and more and we were referred to a paediatrician. She recommended that we change her medication to Movicol. This seemed to help but then again she would become bloated again and then had spasms every night for 7 nights. I found some information on Proctalgia Fugax on the web and showed the paediatrician. She said, although it was not really heard of in children, it did sound like what my daughter was having. She then recommended we try Mebeverine (an anti spasm medication) and again, this seemed to help. Over a course of 6 months I think she only had one episode. I was then advised to take her off the Mebeverine which I have done but then she has since had another two episodes, one of which was extremely painful. My MIL mentioned it when she went to see her nurse and the nurse asked whether it has been suggested she have IBS. I looked it up and my daughter has ALL of the symptoms i.e. bloated, excessive wind, mucus in stools, constipation, pain and discomfort in abdomen and then there is a link to proctalgia fugax! I've been to the doctor today because unfortunately I cannot get a paediatrician appointment until the new year and I asked about IBS. He said that IBS is very rare in children (again, like the proctalgia fugax). He said they would treat IBS with mebeverine so I am to start her on that medication again and see how she goes. I am not sure why IBS wasn't ever even mentioned before. I'd told them about her tummy ache and mucus etc probably 18 months ago. I feel very let down. What I'm wondering is, when she was on the mebeverine before although it helped with the spasms, she did still have a bloated tum and extremely excessive wind. It is really bad. I've had her tested for caeliac disease as some family members have this but it was negative. She eats well too and is very active. I've just started giving her Actimel as someone advised that may help. What else could I try to make things better for her? If I wait for the paediatrican to offer any advice, she'll be an adult herself before we get anywhere. Thank you!
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Difficult...very very difficult.
IBS does occur in children,but does no immediately spring to mind and Proctalgia fugax is associated with IBS and is more common in adults.

Merbeverine is used in both conditions and despite her having two attacks whilst on the drug, I would put her back on it! until she sees her Paediatrician.

You say that she is fit and healthy........that is something to hang onto for the moment
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Thanks Sqad. I should maybe mention she is 5 1/2 now, that is how long this has been going on for. The spasms wake her up at night and come on and off for up to an hour, the last attack was a little over an hour. She has to press down there I think it must be to try and relieve the pain. I have recorded this before and shown the doc/paediatrician. Do you not think its IBS then? Her tummy becomes so swollen sometimes that we cannot buy anything 'fitted' for her. In fact, we have to buy her Age 6-7/Age 7 trousers and roll them up, just so its not tight on her tummy. Her wind is very extreme!! We've been worried about that for a while. It sounds funny but it really isn't for her and I think she may hold it in at school and then explodes when she gets home. She only has to lean over something or press her tummy and she'll let go! She has tummy ache daily and school have often reported this back to me.
jagw

\\\\\Do you not think its IBS then||||

I don't know.

The treatment however is the same as Proctalgia Fugax.

Sorry I havent been much help :-(
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No, you have actually. Thank you. I know it seems like a difficult case. I think its important to say that just because something may be rare, it doesn't mean it never happens. I'll start her on the Mebeverine again as advised by the doc and await the appointment in the new year. Thanks
\\\\\think its important to say that just because something may be rare, it doesn't mean it never happens.\\

In the medical world one should never say never.......cus one day it will occur and hit one in the face......;-)
I have no personal experience of IBS,but I know others who have. This link may be useful,as it focuses on 'FODMAPS' ...a group of foods-Mostly vegetables incliding tomatoes,peppers,etc.that cause irritation and severe bloating in those who are intolerant to them,and is often a cause of IBS.
Since you've not mentioned dietary changes I wonder if your doctors have.

http://www.webmd.com/ibs/features/finding-right-diet-ibs?page=2
Sqad, can she not have mebeverine and movicol? Mebeverine will help the cramps, but she has cramps, wind and bloating because she is constipated. Can't that be treated at the same time?
pixie....I don't see why not.....a good idea.
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Pixie - sorry should have said. The doctor did say that she could carry on with the movicol and the mebeverine. In fact the mebeverine may cause her to be a bit more constipated so the movicol will help. Thanks.
That makes sense. It looked like they were treating half the symptoms half the time then swapping. I hope they find something to help her soon.
I would try an elimination diet. Look it up on Google. You cut out wheat, gluten, dairy, tomatoes, potatoes, peppers, sugar, processed food, pork etc for a couple of weeks and see if she improves. Then gradually re-introduce each food back on one day, then monitor symptoms for 2 days. Then try another. Gradually you'll get some idea whether she is intolerant of a food. Could be something as simple as that!

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