IBS vs. IBD - How Are They Similar and Different?
Both IBD and IBS are chronic gastrointestinal diseases. In addition,
they’re both acronyms, and they even share two out of three letters.
Therefore, mixing up the two conditions is as easy as ABC. But make no
mistake - confusing these two conditions isn’t innocuous, as these two
health issues have very different causes and health outcomes.
Inflammatory Bowel Disease (IBD) is an immune condition that occurs when
the bowel wall becomes inflamed, swollen, or damaged. Irritable Bowel
Syndrome (IBS) is a non-inflammatory condition of the gastrointestinal
tract. And yes, it is possible to suffer from both of these conditions.
But these definitions barely scratch the surface of the many differences
between the two gastrointestinal diagnoses.
Let’s compare and contrast IBS and IBD in this educational article.
Irritable Bowel Syndrome (IBS)
This condition affects the lower GI tract: the large intestine, the
small intestine, and the colon. If you suffer from chronic constipation,
diarrhea, or both, and you feel bloated all the time, you could be
suffering from IBS. The bloating that accompanies this condition may
also make your belly appear large and protruding, even if you’re
exercising regularly and have an otherwise lean and athletic body. Some
people describe the feeling as having a balloon stuck in their stomachs.
This sensation is due to excessive bloating caused by the condition.
Estimates suggest that between 10%-15% of the world suffer from IBS, but
this condition remains poorly understood. Many people suffering from
IBS have normal test results and display no abnormal findings in the
gut. The cause of the condition remains unknown to this day, although
many scientists now believe that bacterial overgrowth or other problems
with gut microbes may be the main cause of IBS.
Other potential causes and risk factors of IBS are:
- Bacterial GI infections (around 70% of IBS patients had severe food poisoning in the past)
- Genetics: you have a family member who also suffers from IBS
- Food sensitivities and intolerances (lactose, gluten, sucrose, fructose)
- Depression and anxiety
Interestingly, IBS is also believed to be triggered by stress and mental health conditions like anxiety or depression. This is why mental health interventions, such as psychotherapy or even antidepressants are sometimes used to treat the condition.
Although IBS is not a life-threatening condition and often has no
complications, it can be very painful and uncomfortable to live with.
Therefore, those who experience any IBS symptoms should definitely seek
medical help (especially since the same symptoms could point to other
serious GI diseases, including cancer).
Inflammatory Bowel Disease (IBD)
IBD occurs when the surface of the bowel becomes inflamed or damaged.
During an inspection, a gastroenterologist can see swelling and sores in
the GI tract. What does it feel like? Diarrhea is the most widespread
symptom, but pain, fever, and bloody stools are also common. Patients
may also have a frequent need to go to the toilet, but when they do,
they experience incomplete bowel movements.
There are two main forms of IBD:
- Ulcerative colitis: recurrent inflammation of the colon.
- Crohn’s disease: inflammation that can develop in any part of the gastrointestinal system.
There’s also a third possible IBD diagnosis - indeterminate colitis - but most cases of this condition eventually develop to either ulcerative colitis or Crohn’s. Both conditions have a strong hereditary component, so patients with a family history of IBD are more likely to develop the condition as well. IBD sufferers are believed to have a weak immune system that allows inflammation to develop in the GI system. Sadly, the exact cause of IBD remains unknown.
The condition can become quite severe, in some cases, and it may cause extreme weight loss or blocked bowels - a life-threatening condition.
Comparing the symptoms of IBS and IBD
Both IBS and IBD can be manifested through the following symptoms:
Diarrhea and urgent bowel movements
Abdominal cramps and pain
Constipation
IBS symptoms are typically limited to the digestive system. IBD, on the
other hand, can cause many other symptoms, even such that don’t involve
the GI tract, namely:
Joint pain
Unintended weight loss and malnutrition
Eye inflammation
Scarring
Rectal bleeding
Another distinguishing feature between the two conditions is pain.
Although it is a common complaint in both conditions - 75% of IBS patients report abdominal pain, as do 50%-70% of IBD sufferers - the localization of the pain can be different.
Most IBS patients experience pain in the lower abdomen, that gets better after a bowel movement, although cramps and sharp pain can also be present in the upper or middle abdomen due to bloating.
In IBD, abdominal pain can happen anywhere in the digestive system, and
patients also often report pain in other parts of the body, namely the
joints, eyes, mouth sores, skin, and rectum.
How common are IBD and IBS?
As mentioned earlier, IBS is a very common health concern. According to gastroenterologists, it is the most common gastroenterological complaint, with 10%-15% of the world population reporting having IBS. IBD is much rarer. Only about 1.3% percent of American adults have IBD, according to the Centers for Disease Control and Prevention (CDC).
Diagnosis and treatment options
Diagnosing IBD is a process that requires more than a physical exam. Lab
tests, endoscopic procedures, and possibly even imaging may be required
to establish the severity of the disease. Although there’s no cure for
IBD, a patient may need a variety of medications, such as antibiotics,
immunosuppressants, or antidiarrheal drugs, to manage the condition and
prevent complications.
In some cases, surgery is also required to remove the badly-damaged parts of the intestine. The complications of IBD can be life-threatening and include:
- Intestinal rupture (perforation)
- a medical emergency that requires urgent surgery
- Bowel obstruction
- a blockage in your bowels
- Colorectal cancer
- Fistulas, or tunnels in the bowel wall that can create holes in the
tissue
IBS is diagnosed very differently. A patient is given an IBS diagnosis
only when other, more serious causes are ruled out. When you seek
medical help, your doctor may have you do a number of medical tests to
make sure that your symptoms are not caused by cancer, IBD, or other
serious health conditions first.
Typically, an IBS diagnosis is made no sooner than 6 months from the onset of the first symptoms. A diagnosis is established when a person experiences symptoms of IBS at least one day every week for the past 3 months. This is done to rule out temporary causes of gastrointestinal symptoms, such as food intolerances or foodborne illnesses.
Like IBD, IBS doesn’t have a cure, but medications, dietary changes,
exercise, and even mental help interventions can significantly help
reduce the symptoms of the condition.