IBS and IBD: What's the difference?!

In a recent post, I described the major need for more education when it comes to IBD.  In a continuation of that effort, today I want to clear up some super common misunderstandings about IBD, and its similar yet not so similar cousin, IBS.

Even pros mistake the two. It’s straight up confusing, especially in a world where we love to speak in acronyms but don’t always stop to explain what those acronyms are.  At first glance, they seem quite similar - both IBD and IBS include symptoms related to the gastrointestinal tract, but there are also significant differences between the two.

Side note: why in the world the “Powers That Be” decided to make it so much harder by giving these two similar things such similar acronyms, is beyond me.  Thanks a lot, “Powers That Be”!

So let’s bring some clarity and get things started with a closer look at IBS and IBD.

IBS 

IBS is Irritable Bowel Syndrome, and is a disorder that affects the gut, specifically the stomach and intestines.  It is often a chronic condition.  Symptoms can include abdominal cramping and pain, bowel urgency, diarrhea or constipation, bloating, excessive gas, and mucus in the stool.  There are three types of IBS: IBS-D, where bowel movements are mostly diarrhea; IBS-C, where constipation dominates with hard, lumpy stools; and IBS-M (the M stands for “mixed”), where both diarrhea and constipation can actually occur on the same day.  Triggers that bring on all IBS types include stress, foods, lifestyle, and medications.  IBS is a disorder/condition/syndrome, not a disease, and has no permanent effect on the stomach or intestines.

IBD 

IBD is Inflammatory Bowel Disease, and to make matters even more confusing, it is the term for not just one, but two chronic diseases of the gut, Crohn’s Disease and Ulcerative Colitis.  Crohn’s and UC are both autoimmune diseases in which inflammation damages parts of the GI tract (in Crohn's the entire GI tract is impacted, in UC the large intestine/colon is the specific target).  The symptoms of both diseases can look an awful lot like all of the symptoms of IBS. However, bleeding with bowel movements is an additional hallmark of both IBD diseases, particularly UC.  Both IBD diseases can be far more severe than IBS, requiring significant medical intervention to try to manage severe symptoms and even prevent death. IBD leads to permanent damage within the impacted parts of the GI tract, particularly the colon (sometimes requiring a total or partial colectomy).  Additionally, IBD can significantly increase the risk of the development of colon cancer.  Like IBS, the triggers can include food, stress, lifestyle and medications.      

So just to hammer it all home, let’s review in bullet point form.

The main similarities between IBS & IBD include -  

• Common symptoms
• Common triggers 
• Both are typically chronic

The main differences between IBS and IBD include -  

• IBD is a disease, IBS is a disorder/condition/syndrome
• IBD is driven by inflammation, in IBS there is no inflammation
• IBD can be much more severe and can require significant treatment, hospitalizations, and surgeries 
• IBD can cause permanent damage of affected gut areas, IBS cannot
• IBD increases colon cancer risk, IBS does not

While IBD is clearly the worst of the two, let’s be real… neither IBD or IBS are pleasant, and anyone who is actively experiencing either one is surely suffering on some level.

The good news is, there’s hope for both!

A variety of medication options are certainly sometimes needed in the treatment of both IBD and IBS, particularly IBD.  But as is true with most conditions, diseases, ailments, etc., both IBS and IBD can be positively impacted by committing to a health-promoting diet and lifestyle.  Completely removing foods that can trigger (like gluten and dairy, for example, as well as highly processed foods, etc.) and incorporating real, whole foods that promote healing and health (like fruits, vegetables, and other nutrient dense foods) can make a world of difference.  

To promote true healing, in addition to changing to a real, whole foods diet, other temporary or long term diet tweaks may be necessary (i.e. removing foods that you are sensitive to, limiting fiber, and for IBS specifically, trying the low FODMAPS diet).  A good Naturopath or Functional Medicine provider can be your hero when it comes to healing both IBS and IBD.  They can test you for food sensitivities (things you may be eating every day which could unknowingly be causing or worsening your symptoms). They can also look at your entire situation on a highly individualized level, and make specific recommendations that aim to cure you, not just put a band-aid on your symptoms.

Additionally, there are many other lifestyle changes that can not just improve your IBS or IBD, but will improve your overall health, disease resistance, and quality of life.  These include prioritizing good sleep, getting regular exercise, making time for rest and play, and dealing with stress and other emotional/mental health concerns.

I speak from experience here as someone who has committed  to a healing lifestyle that has rewarded me with 12 years and counting of being gloriously IBD flare-free.

Let’s keep talking about IBS and IBD, and let’s keep working to clear up the maddening misconceptions.  Better yet, let’s keep working together to create a healthy world without the need for any GI disorder or disease acronyms at all!