Have you ever had a funny feeling in your gut? Maybe it was your instincts kicking in, or maybe it was yet another round of unexplained bloating, pain, and gas. Your gut is at the center of your being, and when something is off, it’s challenging to know if you need to be concerned about it.
Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) both affect your gut health. But what is the difference between IBS and IBD, and which one is more serious? We’ll look at what differentiates these very similar acronyms to leave you informed and empowered as you continue on your journey towards a happy, well-functioning gut.
What Is IBS?
Irritable bowel syndrome is a common disorder that affects your digestive system. In more technical terms, IBS is a disorder of gut–brain interaction (DGBI). This type of condition influences how your brain and gut interact, causing abnormal functioning of the digestive tract. The result is a group of uncomfortable abdominal symptoms. (Source)
The brain and the gut each receive feedback from the other: Your thoughts, emotions, and stress levels can affect what your gastrointestinal (GI) tract secretes and feels like, and how those organs process food. What’s more, your gut activity can also affect your brain by influencing your mood and how you perceive pain. This relationship is commonly called the “gut–brain axis” — what’s happening in your brain affects your gut, and what’s happening in your gut affects your brain. (Source)
Other names for IBS include irritable bowel or colon, spastic colon, and nervous stomach. Irritable bowel syndrome symptoms stem from hypermotility (when your gut muscles are contracting too often), sensitivity in the gut, and from an imbalance in the bacterial makeup of your gut microbiome. These abnormalities are what cause the pain, cramping, and unpredictable bowel movements seen in this DGBI. (Source, Source)
However, it’s important to note that IBS doesn’t damage your digestive tract. Having IBS also doesn’t put you at higher risk for developing other GI conditions such as Crohn’s disease or colon cancer. (Source)
What Causes IBS?
There’s no specific known cause of IBS — researchers believe it depends on a combination of factors. Gut dysmotility is one of those factors, meaning your GI muscles aren’t contracting and moving food through your GI tract efficiently. Having overly sensitive nerves (or “visceral hypersensitivity”) in your GI tract may be another cause of IBS. And when your nerves in the brain and gut are miscommunicating, called gut–brain dysfunction, this malfunction of the gut–brain axis may be another reason for developing IBS. (Source)
What Are the Risk Factors for IBS?
There are different risk factors associated with triggering IBS symptoms. Food sensitivities or intolerances; mental health issues such as depression, anxiety, or a traumatic early-life event; an imbalance of gut bacteria from infection or overgrowth (such as SIBO); and emotional stressors are more common in people who have IBS, leading experts to think they play a role in the onset of this condition. A genetic component is also suspected. (Source, Source)
What Are the Signs and Symptoms of IBS?
There are various symptoms that characterize IBS, all having to do with pain or abnormal function in the gut. Your experience of IBS is unique to you, but common symptoms include:
frequent changes in bowel movements such as diarrhea, constipation, or alternating between the two
the sensation of an unfinished bowel movement
mucus in stool that creates a whitish appearance
It’s possible for IBS symptoms to flare up during menstruation, month after month, which can add to the emotional stress of having IBS. But fortunately, there are ways to manage your flare-ups to improve your mental and physical wellness — more on that soon! (Source, Source)
How Is IBS Diagnosed?
The first step on your journey to being correctly diagnosed with IBS is to bring your symptoms, medical history, and family health history to your health care provider. Your examination should include answering questions about your experience with IBS. Even though talking about your bowel movements isn’t the most pleasant topic of conversation, the more information you bring, the better. (Source)
Because IBS doesn’t create noticeable inflammation or damage to the GI tract, diagnostic imaging tests such as X-rays and CT scans typically don’t provide any information that is useful for diagnosis. An international organization called the Rome Foundation provides criteria for diagnosing IBS and other DGBIs, however. If your symptoms and other relevant health information meet the criteria your IBS diagnosis can be made, bringing you one step closer to successfully managing your disorder. (Source, Source)
Now that you’ve got the basics on IBS, let’s transition to IBD and what to expect with this group of digestive system disorders.
What Is IBD?
Inflammatory bowel disease (IBD) is an umbrella term for a group of digestive system disorders that cause the GI tract to be chronically inflamed. The most common types of IBD are Crohn’s disease and ulcerative colitis. Crohn’s disease can cause pain and swelling anywhere along the digestive tract, from where food goes in to where waste comes out, but in most cases affects the small intestine and upper part of the large intestine. Ulcerative colitis presents as swelling and ulcers in the large intestine. WellTheory has you covered on all the details of IBD if you want to go more in-depth: Check out our Ultimate Guide to Inflammatory Bowel Disease. (Source, Source)
What Causes IBD?
There are 3 potential root causes of IBD, but they don’t account for all the reasons why some people develop these diseases. Genetics is one factor that may contribute to development of IBD, since up to 25% of people who have it have someone else in their family with the disease as well. However, IBD can occur randomly, even when it’s never been part of your family history. (Source, Source)
Inflammatory bowel disease may begin with an improper immune system response. Your immune system is built to fight off infections, but if you have IBD food may be mistaken as an invader with antibodies recruited to fight off the “threat,” causing IBD symptoms. (Source, Source)
Along these same lines, exposure to other environmental triggers, especially for people who have IBD in their family history, may cause the disease to develop. These triggers may take the form of smoking, stress, or medication use. An interesting clue that supports how environmental factors contribute to IBD is that the disease rarely occurs in the southern hemisphere. (Source, Source)
There are health behaviors you may engage in that are risk factors for IBD. Smoking cigarettes is said to be the most important risk factor for developing Crohn’s disease that’s within your control. Taking nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil) and naproxen (Aleve) may increase your chances of developing IBD, or worsen the disease if you’re already living with it. If you’re looking for a different way to manage pain, there are natural alternatives to NSAIDs that may provide you with relief. Just be sure to consult with your health care provider before adding any supplements to your care plan. (Source)
Risk factors also exist outside your control. Age, race or ethnicity, and your family history are all unchangeable factors that may play a part in developing IBD in your lifetime. Most people are diagnosed with IBD before they’re 30 years old, and it develops more frequently in white people than in other races and ethnicities. Demographics aside, you’re more likely to get IBD if you have a close relative with the disease. (Source)
What Are the Signs and Symptoms of IBD?
IBD symptoms typically go through fluctuations. They can be mild or severe, come on gradually or suddenly, and disappear for periods of time. The most common symptoms are:
pain in the belly
diarrhea, constipation, and urgent bowel movements
unexplained weight loss
blood or mucus in stool
There’s also a chance you may experience some of the rarer symptoms of IBD, which include:
Although IBD is a lifelong condition, there’s no evidence it’ll shorten your life expectancy. Proper and holistic treatment can help prevent flares so that you can live your life fully. (Source)
How Is IBD Diagnosed?
While there’s no single test that can diagnose either Crohn’s disease or ulcerative colitis, your care team should investigate your symptoms with you, take a blood draw and stool test, and ask about your family history. An imaging scan, such as an MRI or CT scan, may be able to detect intestinal inflammation. (Source)
Other diagnostic tests may require you to swallow a small camera device that captures images as it travels through your digestive tract, called a capsule endoscopy. A colonoscopy, or other endoscopies that investigate different parts of your digestive tract, can show inflammation and help lead to a correct IBD diagnosis. A combination of these diagnostic tools may be necessary before you know exactly what you’re living with. (Source)
What Are the Similarities Between IBS and IBD?
There are a few similarities between IBS and IBD. They both affect the GI tract, which means symptoms can be similar, with both causing bloating, gas, abdominal pain, constipation and diarrhea, and mucus in stool. Family history is a shared risk factor between the 2 groups of conditions. And the process of diagnosis may start similarly, depending on the types of tests your provider recommends. (Source, Source)
The research into the similarities between IBS and IBD is in its infancy, and more studies on genetic factors, the balance of the gut microbiome, and the gut–brain axis may yet reveal that these two conditions are more intertwined than we know today. (Source)
What Is the Difference Between IBS and IBD?
Similarities aside, IBS and IBD are distinct from one another and have very different prognoses. Inflammatory bowel disease is classified as a group of diseases, and IBS is a syndrome, or a group of symptoms. Irritable bowel syndrome does not cause intestinal inflammation while IBD does, and that inflammation can be destructive and permanently harm the GI tract.
A more invasive exam such as colonoscopy may be used to diagnose IBD because the disease is visible during imaging, whereas diagnosis for IBS is based more on the symptoms you’re experiencing. Finally, IBS carries no increased risk for IBD or colon cancer, whereas there’s an increased risk for colon cancer if you’re living with IBD. (Source)
How Can I Manage IBS?
You may find great success in managing your IBS symptoms through small, yet potent lifestyle changes. Adjusting your diet to include more fiber, better hydration, and less dairy may help improve your symptoms. The low FODMAP diet is another option to explore that may alleviate pain and discomfort. (Source, Source)
Changes outside of diet can look like getting regular exercise, refraining from smoking, maintaining a food log to identify symptom triggers, and trying relaxation techniques to balance out the stress in your life. Receiving support from a mental health therapist could also help you find relief if you’ve found emotional stress to be a trigger for your IBS. Alternative therapies such as acupuncture or hypnotherapy have also shown promise for relieving IBS symptoms. (Source, Source)
How Can I Manage IBD?
Managing the inflammation that comes with IBD is possible with different treatments. There are a range of IBD medications that may help you achieve remission, but as with any pharmaceutical, they come with potential risks and side effects. If you’ve been living with IBD for a long time and medications are no longer providing adequate relief, you may eventually need surgery to remove the unhealthy portions of your GI tract. This surgery looks different depending on your IBD diagnosis, but the end goal is to have your system adapt and start functioning more normally. (Source)
You may find it possible to reduce your symptoms through lifestyle and diet changes. Joining a support group can give you a boost by being around, and sharing experiences with, people who are rising up to meet similar health challenges. There’s some evidence that taking a probiotic supplement may help add beneficial bacteria back into your gut microbiome. And exercising, relaxing, drinking plenty of liquids, eating small meals, and staying away from tobacco and alcohol are a winning combination for treating your IBD symptoms and whole-body health for optimal healing. (Source)
The Bottom Line on the Difference Between IBS and IBD
Irritable bowel syndrome is less severe and comes with fewer long-term complications than inflammatory bowel disease. Both can be managed through healthy lifestyle changes, but IBD often requires medication and surgery along with these changes. Being honest with your care team about all the symptoms you’re experiencing will help you get the correct diagnosis, so you can be empowered with the right knowledge and tools to give your gut the best chance at healing.