IBD vs IBS - What's The Difference?

Do your toilet habits have a big impact on your day-to-day life? If you are one of the estimated 6.5 million people in the UK with bowel problems, then your answer is probably “yes”. Bowel conditions can affect people of all ages and ethnicities and have a significant effect on your ability to enjoy some everyday activities.

You may have heard of the conditions Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). While both of these share a range of symptoms, making them easily confused, they are actually very different conditions, with different causes and treatments.

IBS is considered to be a milder, functional disorder. This means that it’s related to a miscommunication between your brain and your digestive system. It also doesn’t cause any visible damage to your digestive system, despite causing uncomfortable and sometimes debilitating symptoms. Meanwhile, IBD is characterised as the result of one of two main diseases - Crohn’s disease and ulcerative colitis.These can cause physical damage to your digestive system, which in severe cases may eventually need to be resolved with surgery.

What Is IBD (Inflammatory Bowel Disease)?

Inflammatory Bowel Disease (IBD) is a term used to describe two bowel conditions - Crohn’s disease, and ulcerative colitis. The exact cause of IBD isn’t really understood, but it’s believed to be down to an overactive immune system. This means that instead of simply protecting you against disease, your immune system works against your bowel, attacking it and causing it to become inflamed.

The key difference between Crohn’s disease and ulcerative colitis is the area of the digestive system that is affected. Crohn’s disease is characterised by inflammation in any part of the digestive tract and typically occurs in waves that come and go. Meanwhile, ulcerative colitis only affects the colon and rectum and is characterised by continuous inflammation.

What Is IBS (Irritable Bowel Syndrome)?

Many people have heard of IBS and know that it’s a disorder that can cause significant discomfort and disruption to your everyday life, despite the fact that it doesn’t actually cause any visible damage to your digestive system (if a doctor were to examine it). It’s known as a functional digestive disorder, and this is because it involves issues with how your brain and your digestive system communicate, which in turn causes disturbance in your bowel function.

It’s not known exactly what causes IBS, but genetics, stress and anxiety, food intolerances, hormonal changes and side effects from taking some medications have all been linked as possible reasons for it to develop.

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The Key Differences Between IBD And IBS

So, what makes IBD and IBS different? There are a few key things that set them apart from one another.

IBD is a chronic inflammatory condition that can cause real damage to your digestive tract. And this damage can result in symptoms that are generally more severe and long-lasting than those experienced by people who have IBS.

IBS, as we now know, is characterised by a disturbance in bowel function. It can be quite debilitating, but it doesn’t usually lead to any long-term complications, and it doesn’t damage your bowel.

If you have IBD, studies suggest that you could be at increased risk of colorectal cancer. However, there’s no known link between IBS and colorectal cancer.

Treatment between the two conditions varies too. IBD treatment is largely focused on managing your inflammation and the symptoms of your condition using medications and sometimes, surgery. However, IBS symptoms can often be controlled by making some lifestyle and dietary changes, although medications can also be recommended in some cases.

Symptoms - How To Tell IBD And IBS Apart

One of the best ways of telling IBD and IBS apart is through their symptoms. While there is some overlap, there are also some key differences.

IBS Symptoms

Common IBS symptoms include:

• Changes in how often you need to poo, or the consistency or colour of your bowel movements
• Tummy pain, that is sometimes relieved by emptying your bowel
• Abdominal pain that is made worse by stress, or by eating or drinking certain things
• Excessive gas/wind
• An urgent need to poo

IBD Symptoms

Common IBD symptoms include:

• Abdominal pain that isn’t relieved by emptying your bowel
• Blood or mucus (clear slime) in your poo
• Diarrhoea that lasts for longer than 4 weeks
• Bleeding from your bottom
• Feeling tired all the time
• Losing weight without trying
• An urgent need to poo
• Leaking poo from your bottom

Warning Signs That Suggest IBD Rather Than IBS

If you aren’t sure whether you’re affected by IBD or IBS, one way you can tell is to look for the key differentiating symptoms - blood or mucus in your poo, chronic diarrhoea, weight loss, fatigue and leaking poo. These are all indications that you could have Inflammatory Bowel Disease and you should look to get an appointment with your doctor fairly quickly to obtain a diagnosis and find out what treatment is available to help.

How IBD Is Diagnosed

Before you can start any treatment, you’ll need to get an official diagnosis. Diagnosing IBD, like any condition, involves a number of steps. You’ll need to have a physical exam and a range of tests, which will probably include blood tests and stool/poo samples.

Your doctor will talk to you about your symptoms, and ask you about your medical history, including whether or not IBD or any similar conditions run in your family. You may also need to have imaging tests, such as x-rays or CT scans, or an investigative procedure called a colonoscopy.

All of the information from these tests will be used to create a picture that will enable your doctor to confirm or refuse a diagnosis of Inflammatory Bowel Disease.

How IBS Is Diagnosed

Unfortunately, there’s no specific tests that can be used to confirm a diagnosis of Irritable Bowel Syndrome. Instead, you’ll have to have a series of assessments that are not dissimilar to those carried out to diagnose IBD. Your doctor will use the results of these to assess your symptoms against something called the Rome IV criteria to determine if you have IBS. They will also rule out other abdominal or gastric issues.

Treatment Approaches For IBD

There are a range of different treatments for IBD, and which you are recommended will depend on the type and severity of your symptoms.

The medicines used to treat IBD are all designed to work by reducing the amount of inflammation in your digestive system. They do this by controlling your immune system, stopping it from overreacting and attacking the cells in your gastrointestinal tract. This can reduce inflammation and relieve symptoms like pain, diarrhoea and bleeding. These medications include steroids, immune modulators and biologics.

In severe cases of IBD, surgery may be recommended. This usually involves removing the damaged section of your intestine and rejoining the healthy sections together, although there are also some more complicated surgical options, such as an ileostomy. This is where an opening in your abdomen is created to divert bowel movements into a bag rather than through the remainder of your digestive system.

Treatment Approaches For IBS

IBS treatment is mostly focused on managing your symptoms and keeping them under control so that your condition has little impact on your day to day life. Some of the best ways to do this is through diet, exercise and stress management.

Like IBD, certain foods can trigger flare-ups of IBS, and make your symptoms worse. Knowing what these are so you can avoid them, and generally eating a healthy, balanced diet is very important for managing your condition. Regular exercise can help improve your overall digestive health, while getting enough sleep will help you to manage your stress and boost your overall wellbeing.

Exactly what approach to treatment will work best will depend on your individual circumstances and symptoms, and your doctor will be able to help you to figure out an appropriate treatment plan.

In some cases, people with IBS rely on treatments to help them manage their condition. Some of the medications that may be considered could include:

• Laxatives
• Anti-diarrhoea medicines
• Probiotics
• Antispasmodics, to reduce tummy cramping and pain
• Antidepressants, which can help you to cope with pain and anxiety

Living With Bowel Conditions: Self-Management Strategies

If you are living with a bowel condition, you’ll probably know that there are things that you can do to help manage your symptoms to try and limit how much they impact your day-to-day life.

Knowing Your Triggers

You’ll almost certainly find that some foods and drinks will make your symptoms worse than usual. These are your triggers, and by identifying and avoiding these, you can hopefully avoid symptom flare-ups. If you aren’t sure what your triggers are yet, try keeping a diary of what you eat and what symptoms you have, as this could help you figure out what they are.

Dealing With Stress

Having a bowel condition can be stressful, but equally, many people find that high levels of stress makes their symptoms worse. Stress management techniques could help you to keep them under control. Consider activities such as controlled breathing, meditation, yoga or moving meditations like walking to find out which helps you to feel calmer and more in control.

Practical Strategies

When you live with a bowel condition, you may already be familiar with having to be prepared in case a bathroom emergency arises. Nevertheless, if you’re not, it can be a good idea to have a plan in place. For example, checking out where the nearest bathrooms are to wherever you’ll be, planning rest stops where there are bathrooms if you’re travelling, or carrying spare underwear with you. Be sure to take any medication exactly as directed, and if you’re going away, take enough spare so that if you lose any or there’s another problem, you’ve got enough to keep your treatment plan going.

We understand that it might feel uncomfortable or even embarrassing talking about your condition, but it may help to tell family, friends and employers, so that they can support you in any way that you need. You may need to make your boss aware that you might need more bathroom breaks than usual, or that you need to leave a meeting suddenly to go to the toilet.

When To Seek Medical Help

If you are experiencing any of the symptoms we’ve looked at on this page, it’s a good idea to arrange an appointment with your doctor. They’ll be able to discuss them with you and help you to take steps to get a diagnosis and support in place to limit the impact on your daily life.

There are also plenty of groups online that you may like to explore, where you can talk to professionals and other people who are affected, to get advice and support for your bowel condition.

Always Remember...

It is essential that you speak to a licensed medical professional before starting any bowel medication. They can provide personalised, expert guidance, assess potential risks and ensure that your chosen treatment is safe and suitable for your health needs.

IBD and IBS are two very common bowel conditions, but while they share some symptoms, they have very different causes and treatments. It’s essential not to try and self-diagnose your condition, but to speak to a licensed UK medical professional to obtain a proper diagnosis and find out what treatments could help you to manage your symptoms and your condition.

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