People often confuse IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease). It’s easy to see why. They sound the same and some of the symptoms are the same – stomach pain, bloating, diarrhoea or constipation. But they are actually very different conditions, with very different causes and treatments.
However, because they share similar symptoms it is important to get a proper diagnosis so you can receive the correct treatment. Leaving IBD undiagnosed can lead to a worsening of the condition and may lead to an increased risk of colon cancer.
What is IBS?
IBS is referred to as a functional disease. This means there are distinct symptoms but without an apparent physical cause. Scientists are still unclear exactly what causes IBS but it appears to be linked to a range of lifestyle factors such as stress and eating certain foods. Infection and hormonal changes are also believed to play a role. The condition affects how muscles move food through the gut and may also be linked to problems with the immune system.
Symptoms of IBS
People with IBS generally experience two or more of the following symptoms:
- Stomach pain and bloating, often linked to going for a poo
- Diarrhoea and/or constipation
- Change in the consistency of poo
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What is IBD?
By contrast, IBD is a structural disease which means the symptoms are caused by physical damage to your body. This damage is caused by chronic inflammation or ulcers in the gut linked to autoimmune problems. Both Crohn’s disease and ulcerative colitis are inflammatory bowel diseases.
Symptoms of IBD
Like IBS, IBD also causes stomach pain and bloating, diarrhoea and/or constipation. In addition, IBD also causes:
- Blood in your poo or black poo
- Weight loss or loss of appetite
- Inflammation of the joints, skin or eyes
- Worsening symptoms
- An increased risk of colon cancer
Diagnosis of IBS and IBD
Because the initial symptoms can be very similar, your doctor will normally want to rule out an inflammatory bowel disease before making a diagnosis of IBS. The diagnostic tests may include:
- A blood or poo test
- A colonoscopy to look inside your large intestine
- A CT scan
If inflammation in the gut is detected, your doctor will want to carry out further tests to determine if you have Crohn’s disease or ulcerative colitis.
Treatment of IBS and IBD
In both cases, there is no cure for the condition but there are treatments to help you manage the symptoms.
In the case of IBS you may need to avoid trigger foods, such as:
- Dairy products which contain lactose
- Caffeine and beans
- Foods that appear to cause your symptoms to worsen (it can be helpful to keep a food and symptom diary so you know what these are)
If you have diarrhoea you should cut down on fibre, while if you have constipation it can be helpful to eat more fibre. You should drink plenty of water. For some people a low FODMAP diet can be helpful – this avoids certain types of sugar found in fruit, vegetables, bread and dairy products. In some cases, probiotics may be helpful and you can also take medication to help manage the symptoms of diarrhoea or constipation.
Techniques to help you manage stress may also be recommended, such as relaxation training, acupuncture or meditation. Counselling can be helpful.
In the case of IBD, drugs may be prescribed to treat inflammation in the gut and some people also require surgery to repair damage. There are a range of surgical procedures to treat IBD. [Link to IBD blog] IBD increases the risk of colon cancer so people with the condition will be invited to attend regular screening tests.