Many confuse IBD with IBS due to an overlap of certain symptoms. While IBS is also chronic, the two conditions differ greatly, and each requires a different treatment to manage and alleviate symptoms.
IBD vs. IBS
Firstly, IBD is classified as a disease, whereas IBS is classified as a functional GI disorder or syndrome, meaning a group of symptoms.
IBD involves damage and inflammation to the mucosal layer of the intestine and may require hospitalization, whereas IBS does not cause inflammation and rarely requires hospitalization or surgery.
IBD and IBS also require different methods of diagnosis. IBS is detected based on symptoms and cannot be seen through diagnostic imaging, whereas IBD requires diagnosis through endoscopic and imaging procedures, lab tests, and measuring inflammatory biomarkers.
An important distinction between the two conditions is that IBS doesn’t appear to raise the risk of colon cancer while IBD can increase the risk of colon cancer. If you’ve been diagnosed with either Crohn’s disease or ulcerative colitis, you should be screened 8-10 years after diagnosis at regular intervals.
Symptoms of IBS
- Persistent abdominal pain
- Constipation alternating with diarrhea
- Mucus in stool
- Persistent sensation of feeling full
- Abdominal distention or swelling
IBS symptoms can be exasperated after a large meal or a stressful period.
If you’ve experienced weight loss, bleeding, fever, or anemia, it is likely not IBS. These are symptoms of IBD, and you should alert your doctor immediately.
Complications of IBS
IBS patients may suffer symptoms beyond the digestive system. These may include:
- Sleep disturbances
- Temporomandibular joint disorder
- Sicca syndrome
- Back or pelvic pain
- Myalgias (muscle aches and pains)
Symptoms of IBD
- Rectal bleeding/bloody stools
- Mucus in stool
- Abdominal pain
- Tenesmus (feeling incomplete stool evacuation and need for repeat evacuation)
- Severe Urgency
- Gas and bloating
- Loss of appetite or unexplained weight loss
- Nausea and vomiting (more common in CD)
Complications of IBD
Due to the systemic nature of inflammation in IBD, many patients suffer symptoms beyond the digestive system. These are called extra-intestinal symptoms and may include:
- Mouth sores
- Itchy, red, painful eyes
- Joint pain or arthritis
- Skin rashes and sores
- Vision problems
- Liver conditions
Causes of IBS vs. IBD
The main cause of IBS is unknown, but as a majority of IBS patients show elevated levels of anxiety and neuroticism, it is believed to be a disorder of the gut-brain axis, driven by the complex interaction between a dysregulated nervous system, altered brain-gut signals and gut dysbiosis (an imbalance of healthy and pathogenic gut bacteria). IBS symptoms can be triggered by certain foods, stress, infections, hormonal changes, and some medications.
The main cause of IBD is likewise unconfirmed, but researchers believe that several components are involved, including a genetic predisposition, a dysregulated immune system, environmental factors, and gut dysbiosis.
IBD vs. IBS Diagnosis
Differentiating between IBD and IBS is crucial, as they require very different approaches in terms of treatment and management. But they also require different approaches to diagnosis.
This is because IBS is not an “organic” disease, meaning it is not measurable in a procedure due to a lack of difference in the organic tissue. Rather, IBS is a functional disorder, meaning there is an insult to the function of the system itself. Diagnosis of IBS will therefore be based on the presence of specific symptoms and additional tests to rule out other potential causes.
On the other hand, IBD is characterized by an insult to the organic tissue caused by inflammation in the gastrointestinal tract. Diagnosis generally involves a combination of diagnostic procedures, including laboratory tests, imaging studies (for example, an endoscopy or a colonoscopy), and biopsies to identify the presence of inflammation, ulcers, or abnormalities of the digestive tract.
IBD & IBS Treatment
IBD usually requires long-term treatment with anti-inflammatory or immune-suppressing medications, and sometimes surgery.
IBS will require more focus on symptom management with lifestyle changes that may include diet, stress reduction, and medications that target specific symptoms like diarrhea or constipation.