Mom with Teenage IBS Son

My son gets bouts of intestinal cramping, no diarrhea or constipation ever, almost monthly to the date. We have almost completely eliminated gluten, but it is difficult to cook for the entire family at times. The bouts of diagnosed IBS/GERD leave him feeling just awful and tired and sick and not wanting to do anything or go anywhere - not your usual teenage behavior. He has missed 28 days of school already this year. The pediatric gastroenterologist will be doing a colonoscopy and endoscopy at the end of March.

[patientj]

Unless your son has a gluten allergy like coeliac disease (which is diagnosed by a blood test) there's possibly no need to go gluten-free. There is a school of thought that says some people may suffer from gluten intolerance but (a) I think the jury's still out on that and (b) if your son's flare-ups aren't tied to there being gluten in his diet you may be unnecessarily making things hard for yourselves.

Some people with IBS use gluten-free foods so they can avoid wheat. Wheat contains substances known as FODMAPs, which are types of sugars that the body can't digest but bacteria in the gut does digest. This can then trigger the IBS symptoms. The low FODMAP diet is an elimination diet where these foods are cut out of the diet for a few weeks and then gradually brought back into it to see which FODMAPs in particular trigger the symptoms. Because it cuts out lots of common foods it can require some planning initially but is possibly easier than trying to be gluten free all the time as you'd be allowed to eat things that contain gluten and even small amounts of wheat. There are cookbooks and apps out there to help now as well.

Because this is for your son, and you'd probably be cooking the same food to your entire family, it might be sensible to speak to a dietician trained in the low FODMAP diet to make sure all dietary requirements are taken into account. These are available on the NHS but you may want/need to go private instead (see kcl.ac.uk/lsm/research/divi... for a list of trained dieticians).

However, there could be some simple dietary changes that might help instead. Too much sugar and/or fat in the diet could make things worse. And increasing the amount of soluble fibre can aid as well (helpforibs.com/diet/fiber1.... - note that some of the foods suggested in this page can be high in FODMAPs so may also make things worse.

These are all treatments for IBS but maybe the hospital will find other causes. Normally constipation and/or diarrhoea are two of the obvious markers for IBS. And given he is also suffering from GERD I wonder if stress and/or anxiety is at the heart of things. I say this from both personal experience and from various things I've researched about IBS over the last few years.

When I was younger I was quite an anxious kid and on several occasions got stomach cramps when i got worried. There was one notable time when I was on a flight and got cramps when we hit some strong turbulence and the pain went away the second we landed (complete with ambulance waiting there for me on the tarmac!). I'd also got the cramps one year before doing a dance show.

Last year I was suffering from really bad heart burn. Looking back, I realise now that this was when my anxiety was at its peak. Our gut is controlled by the autonomic nervous system and things like anxiety and stress can really wreak havoc with it, perhaps causing spasms (leading to cramps) or relaxing the muscle that keeps the stomach acid from rising up and causing heart burn.

Is it possible he is going through some problems in his personal life or does he have some anxiety in his life? He might benefit from some therapy to help him control any anxiety and talk through any problems he might be experiencing.

[Hidden in reply to patientj]

Thanks! It seems that when we try to introduce a gluten containing food back into his diet, the cramping begins again within 24-48 hours. Hopefully we will get some answers after the procedures at the end of this month.

[denvajade]

Hi there try him on garlic and parsley tablets for a month, if you can't get it do just garlic tablets daily along with a good probiotic. Wishing you well

[Hidden in reply to denvajade]

Thanks!

[rome39]

Hi, First of all thumbs up for the job your doing, not easy with a family also to cook for while having someone with gut issues. If your son reacts to gluten when you reintroduce it, its obvious that for now the best thing is to leave it out.

However, does he still get cramps and GERD even without the gluten?

If that is the case it is obvious that ther is a further rooted cause to his issues. So he could be gluten intolerant or actually might just be reacting to it due to other problems.

Gluten inflames the small intestine much like a bug called H pylori does. If a bacteria like this one is present in the gut, gluten can make things worse.

You know, GERD can be caused by SIBO (small intestinal bacterial overgrowth), food sensitivities, a bacteria called H pylori and even low stomach acid.

GERD is often not cause by overproduction of stomach acid (as is usually believed) but instead from low production, which in turn prevents digestion causing further issues.

Furthermore, SIBO AND H pylori can both cause IBS symptoms. Finding out what is causing his issues will speed things up.

You probably won't be able to get these checked properly by GP or hospitals. However, I hope the procedures you are getting done for your son at the end of the month turn out to be helpful to him.

Best!

[Hidden in reply to rome39]

Thanks!

[BelfastDerm]

Try him on a dairy free diet. And another is eliminate red meat from the diet too

[Hidden in reply to BelfastDerm]

He has been dairy free since age 5, so that is not an issue. And we eat very little red meat anyway. But thank you for your input!

[Sar2262]

Hi MomwithIBSson, 

I had a year of worry over my daughter who is now 19 and the trigger for her illness came as a complete shock to me. 

Basically my daughters IBS was mostly caused by emotional stress. At the time it kicked off really badly she was having a really bad time mentally. She kept this to herself and suffered in silence and I pushed her into lots of tests thinking she was seriosly ill. She was but mentally. Part of her recovery programme has been counselling and mental health support such as relaxation and time out. It seems to be helping manage the severity of her symptoms but not making it go away.  She still has really bad days.

I would very carefully look at your son as a whole person, so as well as the medications, tests etc look to see if there are any stress/emotional reasons he is suffering the way he is. Without this all the meds in the world may not help him. 

In terms of education my daughter tried virtual academy, for her this did not work but is successful for some. One of her stresses was being in a quiet classroom with a digestive system that kicked off. Education have a duty to work with parents to solve issues about attendance. If your son is ill he is ill. I really would not put yourself or him under pressure with regards to attendance. See what the school can do for him so he doesn't fall behind. 

It has been a long and difficult journey for my daughter and one I would not wish on anyone.  We have had to adapt to a different life than what we were expecting for our bright daughter but I have to say we are in a place of relative comfort now after all the greif and worry. Although far from perfect she does have a life. I guess what I am trying to say is that if I had known then what I know now I would have supported her very differently from the beginning.

Wishing you and your son all the best.  

If you want to ask me any question feel free to private message me. 

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