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IBD vs. IBS: What’s the Difference?

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IBD and IBS sound very similar, but they are two different gastrointestinal tract conditions. IBD is short for inflammatory bowel disease. IBS is short for irritable bowel syndrome. 

The only things in common between inflammatory bowel disease (IBD) & irritable bowel syndrome (IBS) are overlapping symptoms, their tendency to affect young people, and both are chronic conditions. 

Please continue reading to learn more about the differences between IBD and IBS.

What is inflammatory bowel disease (IBD)?

Inflammatory bowel disease (IBD) is a group of gastrointestinal disorders that cause chronic inflammation (swelling and irritation) of the gut. These conditions can include Crohn’s disease and ulcerative colitis. 

IBD affects some 3 million Americans. It is most common in young people between the ages of 15 and 30, but it can affect people of all ages, genders, and ethnicities.

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) is used to describe a group of uncomfortable gastrointestinal symptoms such as gut pain, cramps, and excessive gas. 

IBS is a very common disorder. It is estimated that 10-15% of Americans (25-45 million people) have IBS. IBS affects people of all ages, including children. It is almost twice as common in women than men.

What’s the main difference between inflammatory bowel disease and irritable bowel syndrome?

Inflammatory bowel disease (IBD) is a structural disease. Meaning, that there is physical damage to the gut that leads to IBD symptoms. When doctors look at your gastrointestinal tract through imaging studies like X-rays or endoscopy or obtain a biopsy or perform surgery, they can see chronic inflammation and ulcers in the gut if you have IBD. 

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder. Tests don’t show any physical damage in the gut for functional disorders. So, you can have IBS symptoms, but X-rays, endoscopic exams, and blood tests will be normal or negative. Although stress can make functional gastrointestinal disorders worse, they are not considered psychiatric disorders.

What causes inflammatory bowel disease and irritable bowel syndrome?

An inflammatory bowel disease (IBD) such as ulcerative colitis or Crohn’s disease occurs due to chronic (long-lasting) inflammation in the digestive tract. There is a genetic component to IBD (1 in 4 people with this condition have a family history). It is believed to occur due to a faulty immune system response whereby the immune system mistakes foods for foreign substances and launches an attack, which causes IBD symptoms. Environmental triggers like smoking, microorganisms, stress, depression and medication use are risk factors for IBD.

The exact cause of irritable bowel syndrome (IBS) and many other functional disorders is not clear. Scientists think the immune system is involved. IBS is believed to occur due to changes in how muscles move food through the gut (too quickly or too slowly). Triggers such as certain foods, infections, stress, and hormonal changes can make IBS symptoms worse.

What are IBD symptoms and IBS symptoms?

IBD and IBS are both chronic conditions of the gut, and they can cause some of the same symptoms, such as stomach ache, bloating, diarrhea, and constipation. Other similar symptoms include frequent or urgent bowel movements (feeling like you need to poop more often or immediately). 

Additional symptoms of IBD

Besides the above symptoms, IBD can cause gut symptoms like black, tarry stools and weight loss. Other symptoms may include fever and inflammation in other body parts such as the joints, skin, or eyes.

Crohn’s disease, a type of IBD, typically causes pain in the lower right abdomen. Ulcerative colitis, which is another type of IBD, usually causes pain on the left side of the stomach.

Additional symptoms of IBS

Besides the similar symptoms mentioned above, patients with IBS complain of gas, nausea, and a feeling of needing to poop immediately after a bowel movement.

Abdominal cramps and pain from IBS are usually present in the lower half of the abdomen. 

IBS and chronic fatigue syndrome are often present together for unclear reasons.

How do doctors diagnose IBS and IBD?

IBD Diagnosis

Doctors diagnose IBD by looking for signs of physical damage in the GI tract. Tests can help to narrow down what type of IBS you have (Crohn’s disease, ulcerative colitis, or something else) and may include:

  • Blood tests
  • Stool tests 
  • CT scans or MRI scans to examine the small intestine and entire colon
  • Colonoscopy 
  • Biopsy

IBS Diagnosis

Your doctor will obtain a medical history and perform a physical exam. Additionally, physicians use something called the “Rome criteria” to identify IBS patients. This includes having abdominal pain for a minimum of 1 day every week for 3 months and at least two of the following:

  • The abdominal pain occurs with a bowel movement.
  • When the abdominal pain starts, you have more or less frequent bowel movements.
  • Your stool looks different when you have pain.

If your doctor suspects you have something other than IBS, they may order additional tests to make an accurate diagnosis. If there are any structural changes in your digestive system, such as inflammation, or you have symptoms such as rectal bleeding, then it’s not IBS.

What are the complications of IBS and IBD?

If left untreated, inflammatory bowel disease can cause serious health problems and complications such as dehydration, anemia, malnutrition, infections, blood clots, ulcers, blockages in the bowels, perforation (holes in the colon), rapid increase in the size of the large intestine, and an increased risk of colon cancer.

Unlike IBD, IBS is less likely to cause serious complications. However, the symptoms can severely affect quality of life. 

What is IBD treatment?

Doctors use a variety of medications to treat IBD pain and other symptoms, such as aminosalicylates, corticosteroids, immunomodulators, biological agents, and antibodies. Some people with IBD need to undergo surgery to repair the damage caused by Crohn’s disease or ulcerative colitis.

What is IBS treatment?

Medical treatment does not usually work for IBS. However, IBS doctors may recommend over-the-counter medications or offer prescription drugs to IBS patients to help with digestive tract symptoms like diarrhea or constipation. 

Is there a special diet for IBD and IBS?

There is no specific diet for IBS and IBD. However, you can try the following strategies:

  • Eat more fiber
  • Drink more water
  • Avoid dairy products (they contain lactose)
  • Avoid caffeine
  • Avoid legumes (beans)
  • Reduce intake of foods that trigger gassiness or bloating
  • Reduce or avoid FODMAPs, which are simple sugars or carbohydrates found in certain fruits, vegetables, dairy products, and bread

What are some natural treatments for IBS symptoms?

Some IBS patients find complementary and alternative medicine modalities like acupuncture, stress management, hypnotherapy, and relaxation useful. Researchers are studying whether probiotics can be used to treat IBS.

IBS can cause a significant decline in quality of life and consequently lead to anxiety, depression, and other mental health issues. Counseling may be helpful if this is the case. 

IBS support groups are also a great place to educate yourself about the condition and learn from the experiences of others with this condition. 

Can you have IBD and IBS together?

Yes, you can have both IBD and IBS together. It is worth noting that while inflammatory bowel disease (IBD) can cause symptoms of irritable bowel syndrome (IBS), the reverse is not true. Meaning that there is no evidence that having irritable bowel increases the risk of developing gut inflammation (IBD). 
 

References:

  1. https://badgut.org/information-centre/a-z-digestive-topics/the-irritable-gut-ibs-vs-ibd/#
  2. https://my.clevelandclinic.org/health/diseases/15587-inflammatory-bowel-disease-overview
  3. https://my.clevelandclinic.org/health/diseases/4342-irritable-bowel-syndrome-ibs
  4. https://gi.org/topics/irritable-bowel-syndrome/#