IBS Or IBD? Similarities & Differences Explained

IBS Or IBD?

Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are both extremely painful gastrointestinal disorders. They are often confused with one another due to the similarities in their names and the fact that they share some common symptoms. However, these two conditions are vastly different in many ways. Keep reading to learn more about the similarities and differences between IBS vs IBD.

What is IBS?

Irritable bowel syndrome (IBS) falls under the classification of “functional gastrointestinal disorder.” This recognizes the existence of impaired bowel function. The symptoms of IBS can range in severity from mild to disabling, which can negatively affect one’s quality of life, self-image, and ability to function whether they are at work, traveling, or carrying on with daily life activities.

As debilitating as IBS can be, it is classified as a syndrome as opposed to disease, because there are no real signs of abnormalities or disease in those who suffer from it. IBS does not cause the colon to become inflamed and shows no increased risk in the development of colon cancers or IBD. It is very rare for a case of IBS to require either hospitalization or surgery.

IBS affects an estimated 10 to 15 percent of the US adult population, with women being more likely to be affected than men. It also affects almost half of IBD patients – even when in remission (1).

It is one of the most frequently diagnosed conditions by US physicians and the most commonly diagnosed disorder by gastroenterologists, although the causes of IBS are still unclear.  Many individuals who suffer from IBS usually also suffer from other functional disorders such as fibromyalgia, chronic fatigue syndrome, or temporomandibular joint disorder (TMJ). 

What is IBD?

In contrast to IBS, Inflammatory bowel disease (IBD) is a disease whose effects can cause permanent damage to the intestinal tract. IBD causes serious inflammation in the bowels and the digestive tract. Those who suffer from IBD have an increased risk of developing colon cancer. 

The two most common conditions of IBD are ulcerative colitis (UC) and Crohn’s disease (CD). Microscopic colitis is another IBD type that can include lymphocytic and collagenous colitis. Also, some people fall into a category called indeterminate colitis. This classification is used when inflammation is detected but initial tests cannot definitively place it as either UC or CD. Indeterminate colitis will eventually evolve into either UC or CD. 

Ulcerative colitis is the most common form of IBD. This lifelong condition manifests as recurring episodes where inflammation affects the mucosal layer of the colon. It can affect all parts of the colon.

Crohn’s disease has the ability to affect any part of the gastrointestinal tract, from your mouth to your anus. Crohn’s patients have frequent urges to have a bowel movement. However, once they finally do, they feel like they are not able to completely empty their bowels. 

IBS Symptoms

IBS symptoms include:

• Abdominal pain that occurs in any part of the abdomen
• Cramping that feels like waves of cramps
• Bloating
• Constipation
• Diarrhea
• The urgency to have a bowel movement
• Mucus in the stool

In addition, IBS includes sub-types- IBS-D (diarrhea) and IBS-C (constipation). Many IBS patients will alternate between being constipated or having diarrhea, while others will have one but not the other. When IBS patients do have a bowel movement, there is often a sensation that the bowels are not empty. The pain from IBS can be felt all across the abdomen, but most often, IBS patients will feel pain and cramping in either the lower right or lower left quadrant. 

How Long Does IBS Last?

IBS can last for days, weeks or months after the onset. There really is no standard set amount of time. However, if you find yourself in an IBS flare up – nutrition can be incredibly helpful as a first line of defense with IBS. There are many strategies that an IBS focused dietitian can take to help support you. Many dietitians might use a low fodmap protocol for 6 weeks to help you identify which foods might be problematic. However, this isn’t the only effective strategy for IBS – the most important thing is to try to unravel WHY you are having IBS symptoms.

For those of you with IBS and IBD- in our practice we usually do not utilize the low fodmap protocol as a starting point for figuring out symptoms since it is not effective for inflammation. If you’ve got both – consider checking out some of our programs.

IBD Symptoms

IBD symptoms include all of the same symptoms of IBS. They also have additional symptoms that can include:

• Blood in the stool
• Eye inflammation and discomfort
• Extreme levels of fatigue
• Pain in their joints
• Skin sensitivity
• Pain around and bleeding from the rectum
• Weight loss
• Severe urgency
• Sores in their mouths
• Malnutrition

The first sign of IBD is most commonly gastrointestinal pain. When the disease is in symptom remission, IBD patients usually experience less intense symptoms. However almost half of those with IBD in remission will still experience irritation symptoms common with IBS (1).

Things like bloating, diarrhea, constipation, mucus in the stool and abdominal pain can all be a symptom of IBD even when it is in remission. If you are experiencing chronic abdominal pain, rectal bleeding or visible bloating it’s important to let your gastroenterologist know even if inflammation has been ruled out. It could be a sign of other complications.

Is IBD a Disability?

IBD is known as an invisible illness – but did you know it is considered a disability? IBD can impact everyone a little differently depending on the severity and treatment path. While IBD occurs in the digestive tract – it can quite often impact the joints, skin, eyes and more especially for more severe cases. If you find your day to day life is impacted by your IBD – consider what accommodations you might qualify for. Things like handicap passes, accommodations with testing, grants for school, support at work etc might be helpful in making life easier for you

IBS Treatment

While it can seem like IBS is a catch-all term for a collection of symptoms- there are criteria used to identify what IBS is. Your gastroenterologist can access you and diagnose IBS if it is present.

There are very few medical treatments for IBS. It is very rare that IBS is bad enough to require hospitalization or surgery. Each person with IBS is different. What affects one may not affect the other. 

However, we have found in our practice that bringing in strategies to support the microbiome can significantly help improve IBS. Many of the clients we see are surprised that with adjustments, over time they are able to tolerate many foods they weren’t able to previously.

Stress is a factor in making your IBS symptoms worse. While you might not be able to eliminate stress from your life all together – you can focus on changing your response to it. Stress reduction techniques like meditation, mindfulness and diaphragmatic breathing can all be helpful tools for reducing symptoms of IBS.

Discovering what treatment is best for you is like putting together pieces of a puzzle. As you start recognizing which pieces fit for you, you will find yourself feeling better and on the road to a better life.

IBD Treatment

Crohn’s Disease and Ulcerative Colitis must be diagnosed by a gastroenterologist so that the appropriate treatments can be given. Since IBD can lead to other serious conditions if left untreated, it is important to make sure you have a treatment route you feel comfortable with. Your gastroenterologist can help you identify which medications would be best given your medical history and the state of your IBD.

The primary goal of IBD treatment is to reduce the inflammation, improve quality of life and reduce your risk of flare. When you find the right combination of medications, nutrition therapy, and possibly even surgical intervention, you can start feeling better.

Medications 

The following medications are proven to help with IBD:

• Anti-inflammatory drugs: There are a number of different anti-inflammatory drugs for IBD treatment. The type of drug you are prescribed will be based on the areas of the colon affected by your disease. Corticosteroids fall under this classification, as do drugs that are aminosalicylates.
• Immune system suppressors: These drugs are effective because they can suppress the damaging response from the immune system that releases chemicals that only serve to induce inflammation into the body.
• Biologics: This classification of drugs is relatively new to IBD treatment protocols. Biologics work by neutralizing those proteins in the body that cause or aggravate inflammation.
• Antibiotics: Antibiotics are only included when there is a presence of infection during a flare. Overuse of antibiotics when they are not needed can make them less effective when they are needed.
• Anti-diarrheal medications: These can include a fiber supplement or the more standard loperamide (Imodium A-D).
• Pain relievers: When your pain is mild, doctors will recommend acetaminophen-based pain relievers. It is important to know that some of the alternative OTC pain treatments such as ibuprofen, naproxen, or diclofenac can actually aggravate both your symptoms and your disease.
• Nutritional supplements: If it is discovered that you are having trouble absorbing important nutrients, they can be supplemented by vitamins and nutritional supplements.

Nutritional Support

Probably one of the most important treatments of IBD comes in the form of nutrition support. There are many people online that offer solutions, nutrition guidance and even cures for IBD- but as you may have figured out- they are not all the same.

We advise IBD patients to seek an IBD specialized dietitian. In case you weren’t aware, licensed dietitians are actually the only medical professionals able to provide medical nutrition therapy for IBD. 

Here are a few other things to know:

• Medical nutrition therapy is prescribed nutrition designed for a specific condition. This can include dietary and supplement strategies. 
• It’s important to note that personal trainers, bloggers, influencers and people in forums offer nutrition advice but only licensed dietitians can legally provide IBD nutrition support.
• Quality nutrition therapy for IBD differs from generic nutrition advice offered by those less specialized
• An IBD specialized dietitian will have extensive training and experience with the unique needs of an IBD patient 

Quality nutrition for IBD may require a customized plan that considers your symptoms, the level of damage the disease has already done, and food allergies or sensitivities you have.

Lifestyle Changes

Lifestyle changes can affect your IBD in many ways. Bringing in stress resilience strategies is something we work on with many of our clients. Long term perceived stress can actually triple your risk of flare and can amplify symptoms like urgency. 

Surgical Intervention

When diet, medications, and lifestyle changes do not relieve your symptoms, your doctor may choose surgical intervention. These surgeries, known as resections, remove the areas of diseased bowel and reconnect the healthy sections.

Similarities and Differences Between IBS vs IBD

The similarities between IBS and IBD are that both are gastrointestinal disorders that share many of the same signs and symptoms. The primary differences between the two are that IBS is a functional condition while IBD is a disease. 

In Conclusion

There are ways that you can decrease your gastrointestinal symptoms of both IBS and IBD by focusing on your nutrition and lifestyle changes. Our programs have provided relief for many IBD patients. In our programs, we see an 86% reduction in GI symptoms like bloating, diarrhea, constipation, and abdominal pain. We also see a 92% improvement in energy in our individualized program.

Contact us today for more information on how you too can improve your symptoms, decrease your flares, and lead a more normal life.

For more 1:1 guidance that includes a customized-to-you treatment plan, meal planning, coordinating care with your providers, and access to as much support as you need, we recommend reaching out and applying directly to work with us here.

Resources:

Minderhoud, I.M., Oldenburg, B., Wismeijer, J.A. et al. IBS-Like Symptoms in Patients with Inflammatory Bowel Disease in Remission; Relationships with Quality of Life and Coping Behavior. Dig Dis Sci 49, 469–474 (2004). https://doi.org/10.1023/B:DDAS.0000020506.84248.f9