IBS and Gut Symptoms in Children: Why Tests Are Normal but the Pain Is Real

Understanding how the gut brain connection can cause real symptoms in children and what actually helps

If your child regularly complains of stomach pain, nausea, bloating, or urgent trips to the toilet, yet medical tests keep coming back “normal”, it can feel confusing and deeply frustrating. Many parents are left wondering whether something has been missed, whether it is anxiety, or whether they should keep pushing for more investigations.

You are not imagining it. And your child is not making it up.

Ongoing gut symptoms in children are real, common, and increasingly understood through the gut brain connection. When this system becomes dysregulated, children can experience very real physical discomfort even when scans, blood tests, and scopes show no disease.

Can children really have IBS or ongoing gut symptoms?

Yes. Children and teenagers can experience Irritable Bowel Syndrome and other functional gut symptoms. In paediatric settings, these are often referred to as functional abdominal pain disorders, which simply means the gut is not damaged or diseased, but it is not functioning comfortably or predictably either.

These symptoms often begin after a trigger such as illness, surgery, antibiotics, a stressful event, school changes, or prolonged worry. In many children, the gut becomes more sensitive and reactive, staying stuck in an over protective mode long after the original trigger has passed.

What gut symptoms look like in children

Gut symptoms in children can look different from those in adults and they often come and go. Common patterns include:

• Stomach pain that moves around or changes from day to day

• Nausea, bloating, or a spinning or fluttering sensation in the tummy

• Constipation, diarrhoea, or switching between both

• Urgent toilet needs, especially in the mornings

• Symptoms that flare before school, travel, tests, or new situations

• Symptoms that worsen during times of stress or change

Many children struggle to describe what they are feeling, so the discomfort may show up as tears, irritability, school refusal, or withdrawal rather than clear explanations.

Why tests are often normal

This is the part that causes the most confusion and worry for parents.

The gut and brain are in constant communication through nerves, hormones, and the nervous system. This is known as the gut brain axis. When a child’s nervous system is overwhelmed or stuck in a heightened state of alert, the gut can become hypersensitive.

In this state, normal digestive sensations are amplified. The gut muscles may tighten, slow down, or speed up. Pain signals may fire too easily. None of this shows up on scans or blood tests, because there is no structural damage. But the experience of pain is absolutely real.

Think of it like a car alarm that keeps going off even when there is no danger. The alarm system is doing its job too well.

Is this caused by anxiety?

Not exactly. And this is important.

While stress and anxiety can worsen gut symptoms, they are rarely the sole cause. For many children, the initial trigger is physical, such as illness, medication or surgery. The brain then learns to associate certain sensations, situations, or times of day with discomfort, and the loop continues.

Children are not consciously worrying their symptoms into existence. Their nervous system is responding automatically, trying to protect them. Over time, this protective response can become unhelpful and needs gentle retraining.

Why symptoms often flare before school

Many parents notice that gut symptoms are worse in the mornings or before school, even when their child likes school.

Mornings involve transitions, time pressure, separation, and anticipation. These factors activate the nervous system. In a sensitised gut brain system, this activation can quickly translate into stomach pain, nausea, or urgent bowel symptoms.

This does not mean a child is avoiding school or being difficult. It means their body is reacting before their thinking brain has a chance to step in.

What actually helps children with gut brain symptoms

The most effective support focuses on calming and retraining the gut brain connection rather than chasing more tests or restrictive diets alone.

Evidence based approaches include:

• Gut directed hypnotherapy adapted for children

• CBT informed strategies that help the brain reinterpret gut sensations

• Nervous system regulation and calming techniques

• Age appropriate language, imagery, and explanation

• Involving parents so the child feels supported and understood

These approaches are recommended in paediatric gastroenterology guidelines for functional gut symptoms and IBS, and children often respond more quickly than adults because their nervous systems are still highly adaptable.

When further medical review is important

While functional gut symptoms are common, it is always important to rule out medical causes first. Parents should seek medical review if a child experiences:

• Unexplained weight loss

• Blood in stools

• Persistent vomiting

• Pain that wakes them at night

• Delayed growth or puberty

Once these are excluded, focusing on the gut brain connection can be a powerful next step.

A reassuring note for parents

Children with gut brain symptoms are not broken, and they are not destined to struggle with illness or pain forever. With the right support, their nervous system can learn that the gut is safe again.

In my work with children and teenagers, I see time and time again how quickly progress can happen when symptoms are explained properly and addressed at the gut brain level. Children are incredibly responsive when given tools that make sense to their bodies and minds.

If your child is struggling with ongoing gut symptoms and you are looking for a calm, evidence based approach, support is available. 

Support for children and teenagers with ongoing gut symptoms

I work with children and teens who experience ongoing stomach pain, nausea, bowel changes, and gut symptoms linked to stress, illness, or nervous system overload. My work focuses on calming and retraining the gut-brain connection using age-appropriate, evidence-based approaches.

Learn more about my Teen Gut–Mind Program 

👉  Children & Teen Gut-Mind Program