Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are two different conditions that often get mixed up. IBS and IBD don’t only have similar names and abbreviations. They also have a few similar symptoms, like abdominal pain (belly pain), bloating, diarrhea and constipation.
The overlap of symptoms can make it hard to tell which of the two chronic conditions you may have. This article will talk about the key differences and similarities between IBS and IBD, along with common symptoms of each condition. We will also cover the process of getting an accurate diagnosis and how to find support for managing both conditions.
What is the Main Difference Between IBS and IBD?
IBS is a common GI tract condition that affects the digestive system and is used to describe a group of symptoms. IBD, on the other hand, is a broad term used to describe chronic relapsing inflammatory disorders. Forms of IBD include Crohn's disease, ulcerative colitis and microscopic colitis.
Additional differences between IBS and IBD include:
- IBS does not increase your risk of developing other health problems like colon cancer, and it does not cause damage to your GI tract.
- IBD causes chronic inflammation, which may increase the risk of damage to the GI tract and of developing certain types of cancer.
- IBS cannot be diagnosed through blood tests, stool samples or imaging procedures like X-rays, because it does not cause inflammation of the GI tract.
- IBD can be diagnosed through lab tests, stool samples, endoscopic procedures and imaging procedures.
Similarities Between IBS and IBD
Irritable Bowel Syndrome and Inflammatory Bowel Disease are both chronic gut conditions that can affect a person’s quality of life. They can’t be cured, even though they can be managed through different treatment plans. IBS and IBD have many similar symptoms like abdominal pain, diarrhea, bloating and mucus in stool. However, certain inflammatory bowel diseases have additional symptoms, including bloody stools, inflammation, fatigue and weight loss. Bloody stools generally aren't present in microscopic colitis.What is Irritable Bowel Syndrome (IBS)?
Irritable Bowel Syndrome (IBS) is a commonly diagnosed gastrointestinal condition. IBS causes irregular bowel habits. These include recurring diarrhea or constipation. It also causes stomach pain or discomfort when you have no other known health conditions.
Even though most people will have an upset stomach from time to time, people with IBS struggle with symptom flare-ups frequently and with great intensity. IBS can negatively impact a person's quality of life and emotional well-being.
IBS Symptoms
The main symptoms of IBS can be uncomfortable and painful. It’s common to experience more than one symptom during a flare-up. IBS symptoms can vary in intensity from mild to severe and can change over time.
Common symptoms of IBS include:
- Abdominal pain
- Changes in bowel habits
- Diarrhea
- Constipation
- Stomach cramps
- Bloating
- Excess gas
- Mucus in stool
Additionally, around 40–60% of people with IBS also struggle with mental health issues like depression or anxiety.
What is Inflammatory Bowel Disease (IBD)?
Inflammatory Bowel Disease (IBD) is a term used to describe diseases that cause chronic inflammation and irritation of the GI tract. The two main types of IBD are Crohn’s disease (CD) and ulcerative colitis (UC). IBD also includes microscopic colitis.
Crohn’s disease can affect and cause inflammation in any organ in the Gastrointestinal (GI) tract. The GI tract, also known as the digestive tract, is the set of organs that consume, digest and expel food and water. The GI tract includes your mouth, throat, esophagus, stomach, small intestine and large intestine, rectum and anus.
Ulcerative colitis, on the other hand, only affects the colon and rectum.
Microscopic colitis is a chronic disease that leads to inflammation of the colon's inner lining. There are two types of microscopic colitis: lymphocytic colitis and collagenous colitis. In lymphocytic colitis, there is an increase in the number of white blood cells in the colon lining compared to normal. In collagenous colitis, there is a thicker layer of collagen under the colon lining than usual. These are more commonly confused with IBS because they cause less severe symptoms than Crohn’s and UC.
People with IBD often have unpredictable flare-ups. They also have periods of remission with minimal symptoms. There is no cure for IBD.
IBD Symptoms
Similar to IBS, IBD can also take a toll on your emotional well-being. Around 40% of people with IBD also struggle with anxiety. Often, higher anxiety and stress levels happen during IBD flare-ups but will continue even through periods of remission. A common stressor for IBD patients is not being close enough to a bathroom or having to use a bathroom that’s not in their home.
Additional symptoms of IBD include:
- Abdominal pain
- Diarrhea
- Bloody stools and rectal bleeding
- Fatigue
- Weight loss
- Bloating
- Anemia (lack of healthy red blood cells)
- Urgent or unpredictable bowel movements
- Mucus in stool
- Inflammation
The two most common symptoms of Crohn's disease are fatigue and abdominal pain. Watery bowel movements and bloody stools are the most common symptoms of people with ulcerative colitis. Around 83% of people with UC and 64% of CD patients experience urgent bowel movements.
Causes of IBS and IBD
The main causes of Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are still being studied, but the mind-gut connection may be a contributing factor.
Your digestive system and your brain are connected and in constant communication with each other. This is what’s known as the mind-gut connection, or the gut-brain axis. Imbalances in the gut microbiome and certain mental health conditions can increase the risk of developing IBS and IBD.
Your gut microbiome refers to the world of microbes (microscopic organisms), like bacteria, that live in your intestines. These microbes help your body break down food so you can digest and absorb nutrients. When the gut microbes change or become unbalanced, it is known as dysbiosis. Gut bacteria dysbiosis is one of the factors that can lead to IBS and IBD. Chronic stress, post-traumatic stress disorder (PTSD) and anxiety can all dramatically affect gut microbes and lead to dysbiosis.
For IBD, factors like cigarette smoking, sanitation and a weakened immune system play an additional role in triggering inflammation in the GI tract. Genetics are also at play. Someone with a family history of IBD or IBS is more prone to these conditions.
Diagnosing IBS and IBD
Gastroenterologists, or doctors who specialize in conditions that affect the digestive system, diagnose IBS and IBD through different processes.
IBS cannot be diagnosed through tests or lab work. Typically, doctors will diagnose the disease based on a person’s medical history, IBS symptoms that have been present for at least 12 weeks and a thorough physical exam. Often, gastroenterologists will do additional tests to make sure that no other health conditions are behind a patient’s symptoms.
Diagnosing IBD requires a series of tests, which can include:
- Lab tests: Blood tests and stool samples.
- Endoscopic procedures: An endoscopy (for Crohn’s disease), a colonoscopy (for ulcerative colitis).
- Imaging procedures: Magnetic resonance imaging (MRI), computed tomography scan (CT scan), X-rays.
Around 11% of people in the United States have a chronic digestive disease. Adults above the age of 65 are 35% more likely to struggle with a GI disease than younger populations.
Treating IBS and IBD
Often, people with IBS and IBD are encouraged to make dietary and lifestyle changes. The specific changes will vary since different people have different food triggers, habits and symptoms. In some cases, doctors may recommend anti-diarrheal over-the-counter medications for patients with IBS.
Gastroenterologists will often prescribe different types of medications to help reduce inflammation in patients with IBD. Medications like balsalazide and loperamide are also prescribed to patients with IBD.
A healthcare provider can help you discuss different treatment options to help reduce your symptoms and improve your quality of life.
What to Do If You Think You Have IBS or IBD
Sesame offers an affordable and convenient way to get online IBS appointments with board-certified providers. If you're experiencing IBD symptoms and need medical diagnosis or treatment, you can schedule an online doctor appointment today.
