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Differences: Irritable bowel syndrome and inflammatory bowel disease

By Apollo 24/7, Published on - 24 August 2021

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Abdominal pain, cramps, and changes in bowel movements that affect a person’s quality of life could be signs of either irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). IBS and IBD are two chronic conditions that affect the gastrointestinal tract or the digestive tract that runs from the mouth to the anus. Despite having similar symptoms, the conditions are very different with different causes, diagnostic methods, and treatment modalities. Learning the differences between IBS and IBD is important to help make an accurate diagnosis and receive appropriate treatment.

What are IBS and IBD?

IBS is a chronic disorder of the lower gastrointestinal tract (small and large intestine) caused by a disturbance in bowel function. IBS results in a group of intestinal symptoms that typically occur together. Symptoms include pain in the abdomen, constipation alternating with diarrhoea, bloating, and gassiness. It is a condition that needs to be managed long-term and primarily involves lifestyle changes.

On the other hand, IBD refers to a group of conditions that involve chronic inflammation in various areas of the intestine causing damage to the intestinal wall. This condition occurs when the immune system attacks healthy cells in the digestive tract. People with IBD may experience periods of active symptoms followed by periods of remission.

A person can have IBS and IBD at the same time. It is known that 20% of people with IBD also experience symptoms of IBS, and many times, IBS is revealed during the diagnosis of IBD.

IBS and IBD: A Comparison

IBS and IBD differ in the type, causes, and treatment, with a few differences in the symptoms.

Feature

Irritable Bowel Syndrome

Inflammatory Bowel Disease

Description

A syndrome, or a group of symptoms that occur due to abnormal bowel function

A group of intestinal inflammatory conditions such as Crohn’s disease and ulcerative colitis.

Symptoms

  • Abdominal pain and cramps
  • Incomplete bowel emptying
  • Constipation
  • Diarrhea
  • Alternating between constipation and diarrhea
  • Gassiness and bloating
  • Mucus in the stool
  • Abdominal pain and cramps
  • Incomplete bowel emptying
  • Bloody stools
  • Diarrhea
  • Unintended weight loss
  • Loss of appetite

Causes

Caused by a problem with how the brain and digestive system work together, often triggered by stress or food

Caused by an abnormal immune response in the bowel tissue

Inflammation

Does not cause inflammation in the intestine

Causes inflammation and  damage to the intestine

Gender

Women are more likely to be affected than men, usually during adolescence or early adulthood.

Men and women are equally affected, and the condition tends to run in families.

Diagnosis

Diagnosis is made based on the review of the patient’s symptoms and medical history.

Diagnosis may involve endoscopy or colonoscopy to examine parts of the digestive tract, blood, and stool samples.

Risk of colon cancer

Does not increase the risk for colon cancer

Increases the risk for colon cancer

Treatment

Lifestyle changes, diet modifications, and laxatives or anti-diarrheal medications

Anti-inflammatory medications and surgery (in severe cases)

 

What are the differences between IBS and IBD?

Some of the key features that differentiate IBS and IBD are:

  • IBD is a structural inflammatory disease that causes swelling and damage to the gastrointestinal tract. However, IBS is not a disease but a non-inflammatory functional disorder. In IBS, the disturbance between the brain and gut interactions causes the digestive system to behave abnormally without causing any structural damage.
  • IBD primarily occurs in two forms - Crohn’s disease and ulcerative colitis. While Crohn’s disease can involve any part of the digestive tract, ulcerative colitis involves just the large intestine, small intestine, rectum, and anus. IBS can be of 3 types based on abnormal bowel movements: IBS with constipation, IBS with diarrhea, and IBS with mixed bowel habits.
  • IBS and IBD cause similar symptoms such as abdominal pain and cramping, diarrhea, nausea, and/or vomiting. IBS is characterized by gastrointestinal contractions that may be slower than normal causing constipation or rapid causing diarrhea. However, IBD causes more serious symptoms such as anemia, ulcers, and rectal bleeding.
  • There is no known cause for both IBS and IBD. IBS may involve multiple factors or triggers such as food, stress, hormones, or illnesses that cause abnormal bowel contractions. Whereas, IBD is caused by a problem with the immune system where it triggers an immune response to bacteria, food, or other substances in the digestive tract causing inflammation.
  • IBS does not cause ulcers or lesions in the bowel, and the condition is confined to the colon. However, IBD can cause ulcers in the digestive tract which can occur anywhere from the mouth to the anus.
  • Abdominal pain in IBS may involve a wide area of the abdomen but can be confined to the lower-left area. People with IBS may experience pain that becomes severe upon eating meals, with the presence of gas in the digestive tract, or abdominal bloating. However, the pain felt is usually reduced after a bowel movement. In the case of IBD, pain can occur anywhere in the abdomen and the location of pain may indicate the form of IBD. For example - the hallmark symptom of ulcerative colitis is left-sided abdominal pain.

How to manage IBS and IBD

IBS - IBS can be managed with lifestyle changes such as diet and stress management. In a few cases, medications may be required.

  • Dietary changes
  • Including fibre-rich foods in the diet like vegetables, fruits, grains, and nuts or seeds.
  • Avoiding or limiting the intake of caffeine and dairy products.
  • Drinking plenty of fluids or water.
  • Avoiding high-gas foods and gluten-containing foods such as wheat and barley.
  • Exercises and stress management - Regular exercise helps to stimulate bowel movements and combat stress. Aerobic exercises, yoga postures, relaxation techniques like meditation, and deep breathing exercises are recommended.

IBD – The consequences of inflammation in IBD may require medications, hospitalization, and sometimes surgery. The treatment for IBD aims to prevent inflammation and reduce intestinal damage.

  • Medications are prescribed to reduce inflammation. These include amino-salicylates, immune-modulators, and biologics.
  • Surgery may be recommended to remove or bypass the diseased or damaged bowel segment.
  • Managing stress and making dietary changes to reduce consumption of foods that irritate the intestines. Consuming anti-inflammatory foods can help alleviate the symptoms of IBD.

Conclusion

If one is experiencing any changes in bowel habits or symptoms that indicate IBS or IBD, it is crucial to consult the doctor for the right diagnosis and effective treatment. While there is no cure for either of these conditions, the treatment primarily focuses on relieving the symptoms. In people with IBD, medications can help reduce inflammation in the intestines, while IBS treatment involves lifestyle and dietary changes. The right treatment can prevent flare-ups and have long periods of remission that help to improve long-term health and quality of life.

Talk to a gastroenterologist for any questions on digestive health including IBS and IBD.

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