Irritable Bowel Syndrome vs. Inflammatory Bowel Disease
When it comes to the world of gastrointestinal diseases, you may hear a lot of acronyms such as IBD and IBS. Inflammatory bowel disease (IBD) is a broad term that refers to chronic swelling (inflammation) of the intestines. It’s often confused with the non-inflammatory condition irritable bowel syndrome (IBS). Although the two disorders share similar names and some of the same symptoms, they have distinct differences. Learn the key differences here. Be sure to discuss your concerns with a gastroenterologist.
IBS is extremely common. In fact, the International Foundation for Functional Gastrointestinal Disorders estimates that it affects up to 15 percent of the population worldwide. According to Cedars-Sinai, about 25 percent of Americans complain of IBS symptoms. This is also the most common reason why patients seek out a gastroenterologist.
IBS is a distinctly different condition than IBD. Still, a person who has been diagnosed with IBD may display IBS-like symptoms. It’s also important to know that you can have both conditions at the same time. Both are considered chronic (ongoing) conditions.
Some types of IBD include:
- Crohn’s disease
- ulcerative colitis
- indeterminate colitis
Unlike IBD, IBS isn’t classified as a true disease. Instead it’s known as a “functional disorder.” This means that the symptoms don’t have an identifiable cause. Other examples of functional disorders include tension headaches and chronic fatigue syndrome (CFS).
Contrary to popular belief, IBS isn’t a psychological condition. IBS has physical symptoms, but there is no known cause. Sometimes the symptoms are called mucous colitis or spastic colitis, but those names are technically incorrect. Colitis is an inflammation of the colon, whereas IBS does not cause inflammation.
People with IBS show no clinical signs of a disease and often have normal test results. Although both conditions can occur in anyone at any age, it seems to run in families.
IBS is characterized by a combination of:
- abdominal pain
IBD can cause the same symptoms, as well as:
- eye inflammation
- extreme fatigue
- intestinal scarring
- joint pain
- rectal bleeding
- weight loss
Both can cause urgent bowel movements.
IBS patients may experience a feeling of incomplete evacuation as well. Pain may be experienced across the entire abdomen. It most often manifests in either the lower right or lower left side. Some people will also experience upper right side abdominal pain without any other symptoms.
IBS differs in the amount of stool produced. IBS can cause loose stools, but the volume will actually fall within the normal limits. (Diarrhea is defined by volume, not necessarily by consistency.)
IBS sufferers with constipation typically have normal colonic transit times — the amount of time it takes for stool to travel from the colon to the rectum — as well.
Depending upon the main symptom, IBS patients are classified as constipation-predominant, diarrhea-predominant, or pain-predominant.
Since the inflammation of IBD is absent in people with IBS, it’s difficult for researchers to understand the precise causes of the latter condition. One notable difference is that IBS is almost always exacerbated by stress. Stress reduction techniques may help. Consider trying:
- regular exercise
- talk therapy
IBD may flare up in both low-stress and high-stress situations.
According to Dr. Fred Saibil, author of the book “Crohn's Disease and Ulcerative Colitis,” many people don't feel they can discuss IBS because of social stigmas. "You don't hear a lot of people talking about their 'tension vomiting' or 'tension diarrhea' or 'tension bellyaches,'" he says, "even though these are every bit as common."
Dr. Saibil notes also that there’s still some confusion over IBD because doctors once believed that the condition was caused by stress. There’s no evidence that that is the case, however, and IBD patients should in no way feel they brought the condition on themselves.
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IBS may be treated with certain medications such as intestinal antispasmodics like hyoscyamine (Levsin) or dicyclomine (Bentyl).
Dietary and lifestyle changes seem to help the most. People with IBS should avoid aggravating their condition with fried and fatty foods and caffeinated beverages.
IBD treatment depends on the form diagnosed. The primary goal is treating and preventing inflammation. Over time, this can damage the intestines.
IBD and IBS may seem to share similar symptoms, but these are two different conditions with very different treatment requirements. With IBD, the goal is to reduce inflammation that causes symptoms. IBS, on the other hand, may not be treatable with medications because there is not an identifiable cause. A gastroenterologist can help determine your specific condition and offer the best treatment plan and resources to help you manage symptoms.
Which natural remedies will help ease the symptoms of IBS and IBD?
There are several natural remedies and lifestyle changes that may improve your IBS symptoms such as slowly increasing the fiber in your diet, drinking plenty of fluids, avoiding foods that make symptoms worse such as alcohol, caffeine, spicy foods, chocolate, dairy products, and artificial sweeteners, exercise regularly, eat at regular times, and use caution with laxatives and anti-diarrheal medications.
The recommendations differ a little for patients with IBD. If you have IBD, you may need to avoid dairy products, alcohol, caffeine, and spicy foods and you may need to also limit your fiber intake and avoid fatty foods. It is still important to drink plenty of fluids with IBD. You should also eat smaller meals and consider taking a multivitamin. Finally, you should avoid smoking and reduce your stress level with techniques such as exercise, biofeedback, or regular relaxation and breathing exercises.Graham Rogers, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.