IBD vs IBS: Similarities, Differences and Treatments


IBS and IBD are two distinct conditions that affect the gut, with some key similarities and differences. IBD includes a pair of structural autoimmune diseases: ulcerative colitis and Crohn’s disease, both of which cause intestinal inflammation and damage. They may require surgery and hospital stays in severe cases of the disease. Irritable bolus syndrome (IBS) is a functional disease, or syndrome, and is related to intestinal motility (the rate at which food moves through the digestive system) and very rarely requires hospitalization.

We spoke to medical and gut health experts about key similarities and differences between IBD and IBS, including symptoms, diagnostic processes, treatments, and pain. If you suspect you are suffering from either, it is important to see your doctor so they can perform the appropriate diagnostic tests.

IBD vs. IBS: Overview

Both IBD and IBS are gastrointestinal disorders that can cause stomach pain, bathroom issues, and nausea, with the potential to significantly disrupt your daily life. However, IBD is a structural disease, rather than a syndrome, that causes permanent damage to the digestive system through inflammation and increases the risk of developing colon cancer.

There are visible signs of IBD in the intestine that can be seen when doctors perform a colonoscopy (this is how IBD is usually diagnosed). IBS, on the other hand, has no visible signs of damage, is not inflammatory, and does not increase the risk of bowel cancer in those who have it. According to a review in Clinics in Colorectal Surgery (opens in a new tab)the latter is a particular risk for patients with IBD.

“IBS is a functional condition affecting the gastrointestinal tract that gives rise to a wide range of unpleasant symptoms such as abdominal pain, bloating, flatulence, diarrhea and constipation,” says Dr. Deborah Lee. (opens in a new tab), MD. “The exact cause of the disease is not well understood, but there is a miscommunication in the gut-brain axis. The gut becomes hypersensitive to certain foods.

Dr Deborah Lee doctor

Having worked for many years in the NHS, first as a general practitioner and then as a senior clinician for an integrated community sexual health service, Dr Deborah Lee now works as a medical and health writer, focusing on women’s health. She is a specialist in menopause.

“IBD is the term used to describe two specific medical conditions that affect the gut – Crohn’s disease and ulcerative colitis. Symptoms are similar to those of IBS with abdominal pain, bloating and diarrhea. However , in both of these conditions, the intestine becomes inflamed, Inflammation damages the intestinal wall, with the long-term risk of strictures (scar tissue in the intestinal wall) and/or intestinal perforations, which are life-threatening and can be fatal.

IBD vs. IBS: Symptoms

IBD and IBS are similar in some ways. Both conditions cause abdominal pain, bloating, mucous stools, and diarrhea, but rectal bleeding, anemia, and unexplained weight loss are just signs of IBD. Because IBD is an autoimmune disease, it can also cause swelling in the joints, eyes, and skin, and sometimes alopecia.

Although we don’t know exactly why hair loss is associated with IBD, a study published in the Word Journal of Gastroenterology (opens in a new tab) found this to be a common symptom. IBD can also trigger secondary autoimmune diseases in those who have it, according to another World Journal of Gastroenterology (opens in a new tab) study.

woman leaning on her bed with digestive pain

(Image credit: Getty Images)

People with IBS will often have a sense of urgency when using the toilet, but this tends to change or go away after a bowel movement. With IBD, patients often suffer from faecal incontinence according to a study published in the Journal of Crohns and Colitis (opens in a new tab), which has been shown to have a significant impact on quality of life. It is thought that around 24% of people with IBD are affected overall, although 74% of respondents in this particular study said they had suffered from faecal incontinence. Although people with IBS also have faecal incontinence, it is usually only in severe cases, with 14-20% reporting this symptom to a neurogastroenterology and motility department. (opens in a new tab) Review study.

“There are different types of IBS, and the symptoms someone experiences tell us a lot about what type of IBS they may have,” says Caitlin Hall, dietitian and clinical research manager at Myota. (opens in a new tab).

caitlin hall apd

Caitlin Hall is a Registered Dietitian (CRD) and Clinical Research Manager at Myota. She holds a doctorate in neuroscience and intestinal microbiology. His research combines functional neuroimaging and microbiome sequencing to understand how the gut microbiome influences the dynamics of the human brain network supporting anxiety. She is passionate about translating research on the gut-brain axis from preclinical models to human studies, and exploring the potential for future applications in clinical settings and general health.

“IBS-C refers to where constipation is prevalent and IBS-D refers to diarrhea as the main symptom and with IBS-B (or IBS-M) it is a combination of the two. Whatever type, it is always important to rule out other conditions such as celiac disease and inflammatory bowel disease, as many symptoms overlap.

IBD vs. IBS: Pain

Pain is a symptom that characterizes both IBS and IBD, and can be debilitating in both cases.

“Both conditions cause cramping and lower abdominal pain,” says Dr. Lee. “However, IBD tends to cause pain lower down on the left side of the abdomen, whereas IBS causes generalized discomfort throughout the area.

“The pain of IBD is often more intense and has been described as a twisting knife in the gut or sometimes compared to labor pains. This can cause the patient to lean forward holding their stomach at the Agony People with IBS too often experience severe pain, using words to describe it as unbearable, indescribable, excruciating, and intense.

IBD vs. IBS: Treatment

IBS and IBD require different treatment plans due to how they affect the body. Treatments for IBS tend to be symptom-based, as there is no physical damage, so lifestyle changes such as a low-FODMAP diet may be recommended.

Treatments for IBD can be pharmacological or sometimes surgical, if the disease is severe. In the most severe cases, a stoma may be considered, bypassing the bowel temporarily or permanently. It can be a planned procedure or can be done in emergency circumstances if a patient is in crisis.

Patients with IBS and IBD may benefit from therapies to help manage stress and anxiety, as both conditions are often linked to poor mental health. According to a study published in Clinical and Experimental Gastroenterology (opens in a new tab). Another study in the European Archives of Psychiatry and Clinical Neurosciences (opens in a new tab) found that, compared to healthy control subjects, patients with IBS had significantly higher levels of anxiety and depression.

woman holding her stomach as a doctor diagnoses her stomach pain

(Image credit: Getty Images)

“Treatment for IBD can include medications like aminosalicylates (5-ASA), corticosteroids, immunomodulators, and biologics,” says Hall. “How IBD is managed is very individual and treatment may also need to change over time; some people may also eventually require surgery, including bowel resections, colectomy, colostomy. The role of diet – particularly the Mediterranean diet – is now also recognized as playing a key role in the effective management of IBD. Dietary recommendations should emphasize high fiber content – including prebiotics – healthy fats and diversity of fruits and vegetables”

Hall also says that about 30% of people with IBD also have concurrent IBS. For example, when people with IBD are in remission (when symptoms lessen or disappear, often temporarily), they will continue to experience bowel hypersensitivity such as pain and impaired bowel function, in the absence of inflammation. .

This article is for informational purposes only and is not intended to offer medical advice.


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