ibs vs ibd what are the similarities and differences

Have you ever been explaining your child's IBD diagnosis to a friend or family member only to receive the reply, “I totally understand what you guys are going through. I have IBS!” You may be frustrated by this response because you know that there are major differences between IBD and IBS. In fact, you can start rattling off a whole laundry list of differences! Or, perhaps you understand that IBS and IBD are two different disorders, but you are not quite sure what the differences are. After your child's diagnosis, you may feel confident in your understanding of IBD, but what really is IBS? Are there any commonalities between the two disorders? What does IBS even stand for anyways? However you may be feeling in this situation, whether you are angry, annoyed, hurt, or confused, your response to this type of comment matters. You can choose to view moments like these as unique opportunities to spread IBD awareness by politely imparting your knowledge. Remember, common misconceptions are shattered one individual at a time! It is possible to respectfully share knowledge and build a strong connection without belittling or demeaning the individual or their disorder. This page is intended to arm you with some basic knowledge about IBS and IBD, taking care to highlight the similarities and differences between the two disorders.

Before we dive into the content, please note that this page is not intended to be a substitute for a professional medical opinion. For more detailed information regarding IBD or if you have questions pertaining to your child's individual treatment plan, please seek out the professional medical advice of your child's doctor. Additionally, please note that this page provides a brief overview of IBS and IBD and does not discuss these disorders in great detail. If you have any specific questions pertaining to either of these disorders you can always speak with your child's doctor or another healthcare professional. Now let's begin!

IBS

What is IBS?

Irritable bowel syndrome, or IBS, is a functional gastrointestinal disorder characterized by chronic abdominal pain or discomfort and alteration of bowel patterns. Diarrhea or constipation may predominate or alternate. The symptoms of IBS can range from mildly annoying to chronically debilitating, impacting overall quality of life, social life, and an individual's ability to work or travel. Individuals with IBS may feel less able to take part of normal, daily activities. IBS is fairly common, as it is estimated that around 12% of the United States population has been diagnosed with IBS. In the past, medical professionals have referred to IBS as IBS colitis, colitis, mucous colitis, spastic colon, spastic bowel, and nervous colon. The antiquated terms “IBS colitis” and “colitis” should not be confused with ulcerative colitis, one type of IBD. The older terminology certainly can contribute to the confusion between IBS and IBD! Unlike IBD, IBS does not cause any digestive system damage, as it is largely a disorder of gut/brain interaction.

What are the Symptoms of IBS?

Common symptoms of IBS include:

Chronic/persistent abdominal pain

Mucus in the stool

Gassiness/flatulence

Abdominal bloating or abdominal distention

Sensation of feeling full

Change in stool frequency

Change in stool appearance

Nausea

Urgency

Sensation of incomplete evacuation

Non GI symptoms: fatigue, headache, sleep disturbances

What Causes IBS?

Just like with IBD, the exact cause of IBS is unknown. Psychological stressors, such as depression, anxiety, physical/sexual abuse, and PTSD, are associated with the development and exacerbation of IBS symptoms. However, there is a significant amount of researching pointing to the fact that IBS is a disorder caused by a disturbance between the brain and the gut, meaning that there are poorly coordinated signals between the brain and the intestines. This can cause the body of an individual with IBS to “overreact” to the typical digestive process, leading to many of the common IBS symptoms. Additionally, individuals with IBS typically have overactive muscle contractions in the intestines. The walls of the intestines are lined with layers of muscle, and the contractions of these muscles help to move food through the digestive tract. In an individual with IBS, the contractions can last longer and be stronger, which can lead to several different IBS symptoms. There is some research looking into mental health/stress, severe GI infections, food allergies, and changes in gut microbes as potential causes or contributors to the development of IBS. More research is needed in this area.

How is IBS Diagnosed?

IBS is diagnosed based on the symptoms of the patient and the elimination of other disorders/causes. IBS cannot be confirmed by imaging or other diagnostic tools, as is the case with IBD, however these tools can be used to eliminate other disorders as the root cause of symptoms. Thus, blood tests, stool tests, x-ray, and/or endoscopy/colonoscopy may be ordered to rule out other disorders (e.g. colorectal cancer, IBD, endometriosis, lactose intolerance, celiac disease, etc.). Once these disorders are ruled out, IBS is diagnosed using the Rome IV criteria. This requires that the patient have recurrent abdominal pain on average at least 1 day per week during a 3 month period that is associated with two or more of the following:

Related to defecation

Change in stool frequency

Change in stool form/appearance

How is IBS Treated?

No single therapy is effective for all IBS patients. Treatment is different for everyone but may include psychological therapy/changes, dietary and lifestyle changes, and/or medication therapy.

Psychological: Cognitive behavioral therapy and stress management techniques may help a patient to cope with any psychological factors that may be exacerbating IBS symptoms.

Lifestyle changes: Regularly exercising may help to reduce bloating and constipation, as well as improve psychological factors that may be contributing to IBS symptoms. Many individuals with IBS find that following a special diet, such as a low FODMAP diet, can be very effective at reducing and managing symptoms. For those with constipation, an adequate fiber intake is necessary. Some individuals find that reducing dairy in their diet shows improvement in their IBS symptoms.

Mediations: In severe cases of IBS, medications can help to reduce symptoms. Medication therapy is highly individualized for patients with IBS. There is no one medication that is most effective or works well for every single IBS patient.

IBD

Chances are that if you are reading this page, you are intimately familiar with what inflammatory bowel disease, or IBD, is. For this reason, we will only briefly discuss IBD in this post. For more detailed information on IBD, including the difference between Crohn's disease and ulcerative colitis, please feel free to refer to my “What is IBD?” blog post. The link is at the bottom of this page. For the purposes of this post, the following information on IBD will be brief and will not dive into too much detail.

What is IBD?

Inflammatory bowel disease (IBD) is defined as a chronic inflammation of the GI tract. In an individual diagnosed with IBD, the body is triggered to produce an exaggerated, inappropriate immune response that results in GI tract inflammation. IBD is therefore considered to be an autoimmune disease. The resulting prolonged inflammation can cause tissue destruction and damage to the GI tract. IBD is characterized by periods of remission and periods of exacerbation.

What are the Symptoms of IBD?

Some of the common symptoms of IBD include:

Persistent diarrhea

Weight loss

Fatigue

Abdominal pain

Bloody stools

Please note that this is not a comprehensive list of all IBD symptoms. Additionally, there are some differences in symptoms between the two types of IBD. For example, weight loss is more common in those diagnosed with Crohn's disease, whereas bloody stools are more prevalent in those diagnosed with ulcerative colitis.

Unlike IBS, IBD patients can experience many different complications related to their disease.

Local complications can include:

Hemorrhage

Strictures

Perforation

Abscesses

Fistulas

C. difficile infection

Toxic megacolon

Systemic complications can include:

Skin, eye, and joint inflammation

Mouth ulcers (in those with Crohn's disease)

Gallstones

Kidney stones

Liver disease

Osteoporosis

Blood clots

Dehydration

Malnutrition

What Causes IBD?

Unfortunately, the exact cause of IBD is unknown. However, we do know that the disease is a result of a weakened immune system. In a patient with IBD, the individual's immune system develops an overactive, inappropriate immune response to the body's own GI tract. The most widely believed theory is that IBD is the result of an environmental trigger that causes an inappropriate, uncontrolled immune response in a genetically prone individual.

How is IBD Diagnosed?

In order to diagnose IBD, a full history of symptoms and a physical examination will need to be completed by the doctor. After all other conditions are ruled out, IBD is usually diagnosed based on certain tests, such as endoscopy, enteroscopy, sigmoidoscopy, and/or colonoscopy. Imaging studies (X-ray/CT/MRI) are sometimes necessary and can also be useful in diagnosing IBD.

How is IBD Treated?

There is no cure for IBD, but there are several different methods of IBD treatment, all with the goal of achieving and maintaining remission. These methods of treatment are:

Medications

Anti-inflammatory drugs

Aminosalicylates

Corticosteroids

Immune system suppressors

Biologics

Antibiotics

Anti-diarrheal medications

Surgical therapy

Nutritional therapy

Rest

Counseling and/or support group if desired

To summarize what was discussed on this page, please feel free to refer to the Venn Diagram included in this post. This diagram is not an exhaustive list of all the similarities and differences between IBS and IBD, but does highlight some of the key points discussed in this post. As mentioned above, if you have any questions or want to discuss this matter further, please contact your child's doctor or other healthcare professional. It is my hope that this page provided you with a basic overview of the commonalities and vast differences between IBS and IBD. The next time that someone tries to compare IBD to IBS, remember that you have the opportunity to start shattering the misconception that these disorders are the same thing. You have the ability to kindly impart your knowledge in a gentle and loving way, without making light of anyone's disorder or pain. As always, stay strong IBD Warrior parents!

Lewis, Sharon et al., Medical-Surgical Nursing: Assessment and Management of Clinical Problems (St. Louis, Missouri: Elsevier, 2017), 940

Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. Journal of the

American Medical Association. 2015;313(9):949–958.

Definition and Facts for Irritable Bowel Syndrome

Definition and Facts for Irritable Bowel Syndrome

Lewis, 940

Lewis, 944.

Lewis et al., 944.

Lewis, 946.

Centers for Disease Control and Prevention, What is Inflammatory Bowel Disease?

Lewis, 944.

Alatab et al.

Bibliography

Alatab, Sudabeh, Sadaf G Sepanlou, Kevin Ikuta, Homayoon Vahedi, Catherine Bisignano, Saeid Safiri, Anahita Sadeghi, et al. “The Global, Regional, and National Burden of Inflammatory Bowel Disease in 195 Countries and Territories, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017.” The Lancet Gastroenterology & Hepatology 5, no. 1 (2020): 17–30. .

Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. Journal of the

American Medical Association. 2015;313(9):949–958.

“Definition & Facts for Irritable Bowel Syndrome - NIDDK.” National Institute of Diabetes and Digestive and Kidney Diseases. U.S. Department of Health and Human Services. Accessed April 6, 2023. .

Lewis, Sharon Mantik, Linda Bucher, Margaret McLean Heitkemper, and Mariann M. Harding. Medical-Surgical Nursing: Assessment and Management of Clinical Problems. St. Louis (Miss.): Elsevier, 2017.

“What Is Inflammatory Bowel Disease (IBD)?” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, April 13, 2022. .