Can kids and adults have IBD and IBS?

When doctors are trying to make the diagnosis of IBD (Crohn's or ulcerative colitis), we usually try to make sure that's exactly what they have. It's often easier when there's blood in the toilet or when they wipe or when kids aren't growing or gaining as they should. But when they don't have blood, weight loss or growth problems, when they come in with just pain and diarrhea, we have to be careful to make sure they don't have IBS (irritable bowel syndrome) instead.  

But sometimes, they can have both IBD and IBS. Double whammy. And of course, they feel worse, even when their Crohn's or colitis are under control. Not unexpected. Let's give you the details. 

Functional Abdominal Disorders

IBS, abdominal migraine, functional abdominal pain and dyspepsia (what most people think of as indigestion) are grouped together as functional abdominal pain disorders. Their stomach and intestinal symptoms are often explained as disorders where there is a gut and brain (or nerve) interaction. This includes problems where someone is particularly sensitive ("hypersensitive") to pain in the intestine, or where movement of food and waste is altered. Since repeated injury, infections or surgery in the abdomen (what people often call "the belly") can the area more sensitive to pain, it's not surprising that patients with IBD can also have one of these disorders, even when their IBD is in remission. (In fact, it can be hard to sort out how much is functional pain and how much is from IBD when IBD is in a flare.

How Common Are Functional Abdominal Disorders? 

Seemingly healthy people have IBS and other functional pain disorders too. In fact, about 8 to 12% of school-age kids have these problems. They miss a lot of school and activities and need medicines and sometimes need diets or other measures to help. But kids with IBD have problems with functional abdominal disorders 26% of the time, according to a study of 71 kids done at Nationwise Children's Hospital in Columbus, Ohio (JPGN, 2017, pp212-17). That's 2 to 3 times as often. IBS accounts for about half of the functional pain in IBD kids. 

In adults, about 35% of those with IBD also have symptoms of IBS. That's about 3 times as many. And that's interesting (as well as sad) because it may suggest that the longer someone has IBD, the more likely they are to develop IBS. 

Oher statistics are just as troubling:

• Girls are 2 times more likely to functional disorders with their IBD
• 14% of the kids with both have anxiety
• 24% of the kids with both have depression 
• Children with mothers who had IBS had more symptoms of depression and reported more GI complaints

Adults with IBD and IBS don't seem to be much different.

Important points:

• Symptoms may not always be from an IBD flare, but could be from IBS, triggered by stress or other causes. 
• Anxiety and depression can result and cause further problems. 
• A cycle can develop where anxiety and depression then cause more IBS symptoms   
• While IBS symptoms are more common in girls and women, boys and men can have IBS too