IBS v. IBD: the great intestinal debate

December 18, 2012 at 3:37 pm 3 comments

There is no worse feeling than someone telling you that they know what you are going through because they have IBS. Sadly, not many people realize that there is a significant difference between IBS and IBD. I know this firsthand because I have IBS while Dan has IBD. Below I explain the two illnesses and the differences between the two.

IBS: Irritable Bowel Syndrome

IBS is a symptom-based disorder that affects your large colon. People with IBS experience bouts with cramping, diarrhea, constipation, and bloating. IBS doesn’t cause any permanent damage to your colon.

For most people, IBS symptoms improve as they learn how to control their condition. Only a small number of people with IBS actually experience crippling signs and symptoms. The signs and symptoms of IBS can be managed by changing your diet, lifestyle, and stress.

I know for me, my IBS episodes only happen a few times a year. My IBS is typically  a short period of debilitating cramps and diarrhea followed by several days of constipation. My episodes are triggered by two things:  over-consumption of dairy and/or caffeine and anxiety attacks. I have actually caused myself to have IBS episodes by having a severe panic attack (which is awesome because I then start to panic that I’m going to have an IBS episode, a nice circle effect).

IBS is typically treated with anti-diarrhea medications (like Imodium), anti-spasmodic medications (like Bentyl), antidepressants, fiber supplements, and elimination of high gas foods. There are currently two prescription medications approved specifically for the treatment of IBS: Lotronex and Amitiza. These are taken after other therapies haven’t worked.

IBD: Inflammatory Bowel Disease

IBD, unlike IBS, causes the inflammation of all or part of your digestive tract. It causes watery diarrhea, rectal bleeding, abdominal cramps, pain, fever, and weight loss. It can be extremely painful and debilitating, and sometimes leads to life-threatening complications.

Like most of you reading this blog, Dan experiences IBD episodes multiple times a day, some days worse than others. He experiences bouts of cramping, diarrhea, and nausea daily. IBD is controlled through medications, like anti-inflammatories, immunosuppressants, antibiotics, corticosteroids, and, if necessary, surgery. IBD symptoms can also be improved by modifying ones diet and eliminating the consumption of trigger foods.

IBS versus IBD: The Differences

Despite the obvious differences, some patients with IBD are originally misdiagnosed with IBS and go without appropriate treatment. Here are the major differences between the two ailments:

IBS is a functional disorder; IBD is a chronic illness.

IBS does not cause any GI inflammation; IBD causes chronic inflammation of the GI tract.

IBS does not cause permanent damage to your colon; IBD does.

IBD does not cause changes in bowel tissue; IBD does.

IBS doesn’t increase your risk of colorectal cancer; IBD does.

IBS is not a life-threatening condition; IBD can be.

IBS does not cause bleeding or black stools; IBD can.

Patients with IBS have a “normal” looking gut; Patients with IBD do not.

IBS does not cause fistulas or strictures; IBD does.

IBS can be treated with diet and lifestyle changes; IBD requires treatment with medication as well as diet changes.




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3 Comments Add your own

  • 1. ibsimpact  |  January 9, 2013 at 1:13 am

    Yes, it’s true that IBS and IBD are different disorders and you are fortunate that your own IBS is mild and sporadic and responds well to diet and lifestyle changes. But that is not the case for everyone. Medication options are relatively limited, and most of those each only work for a small subset of people with no way to tell if you are one of them without trial and error. For some of us, even virtually the entire range of interventions that currently exist aren’t really adequate and IBS is disruptive or disabling on a much more chronic basis. Until fairly recently, IBS experts did believe that a very small percentage of people were significantly affected, but in 2011, some of those same experts, in a Rome Foundation report (the same entity responsible for the Rome III diagnostic criteria) acknowledged that this percentage is much higher than they themselves believed, with about 40% mild, 35% moderate and 25% severe, rather than the previous estimates of 70% mild, 25% moderate and 5% severe.

    Functional GI research is also increasingly blurring the distinction between functional and organic and finding evidence of physical changes and inflammation in some peope with IBS. It’s just not as overt as in IBD, and can’t be picked up by existing clinical tests, only in research. So while many of the statements in your post are correct, a few are not completely up to date.

    Best wishes to you and all with GI disorders, whether IBS or IBD.

  • […] IBS v. IBD: the great intestinal debate […]

  • […] was diagnosed, I didn’t know much about IBD. In fact I was one of those people who thought IBD and IBS were one in the same (I now know that they are most definitely […]


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