People often confuse two common but different conditions: Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). IBD and IBS can affect the esophagus, stomach, and intestines and both result in gastrointestinal discomfort. However, they differ in their underlying causes and severity.
How can you tell the difference between IBD and IBS? IBD involves inflammation and autoimmune responses, while IBS is a disorder characterized by symptoms without evident physical damage or inflammation.
When I talk to patients, my first ways to clarify which condition is at play are to identify the severity of symptoms and discuss any previous autoimmune issues the patient has experienced. Very severe gastrointestinal symptoms or a history of autoimmune disease both point strongly to IBD.
What Is IBS?
Irritable Bowel Syndrome (IBS) is a disorder that affects almost a quarter of American adults. Sometimes called spastic colon, it causes abdominal pain, diarrhea, constipation, or both. It is defined as a group of symptoms and, therefore, a syndrome, not a disease.
IBS falls under the category of functional gastrointestinal disorders, where symptoms manifest without any evident structural abnormalities.
Is IBS worse than IBD? IBS does not involve the chronic inflammation seen in IBD, but it can significantly impact an individual’s quality of life due to the often disruptive nature of its symptoms.
While some gastroenterologists claim IBS is a chronic condition, we at PrimeHealth address the root cause of symptoms. In doing so, we’ve witnessed amazing success and reversed IBS in patients. If you are struggling with IBS and live in the Denver area, schedule a free consultation with PrimeHealth.
What is IBD?
Inflammatory Bowel Disease (IBD) is classified as a disease and consists of a group of chronic inflammatory conditions that affect the gastrointestinal (GI) tract. It is characterized by chronic, sometimes destructive inflammation in the intestines.
The two primary types of IBD are Crohn’s disease and ulcerative colitis.
What is the difference between Crohn’s and ulcerative colitis? Crohn’s disease is generally more severe and can affect any part of the digestive tract, sometimes skipping healthy tissues between inflamed areas. Ulcerative colitis occurs when there is continuous inflammation in the inner lining of the colon and rectum.
Symptoms of IBD vs. IBS
The distinction between IBD and IBS can sometimes blur because they exhibit similar symptoms. Common symptoms for both conditions include:
- Abdominal pain
- Bloating
- Cramping
- Changes in bowel habits
- Diarrhea
- Constipation
Additional symptoms of IBS include:
- Nausea
- Gas
- The feeling that you still need to go after a bowel movement (called “incomplete evacuation”)
IBD is often accompanied by more severe symptoms, such as:
- Rectal bleeding
- Weight loss
- Anemia
- Fatigue
- Joint pain
- Rashes
- Eye inflammation
Causes of IBS
The primary cause of IBS is multifactorial, meaning any number of many different factors can cause it. Researchers believe that a combination of physical and mental considerations can influence its onset.
Some of the root causes I and other providers at PrimeHealth investigate when diagnosing IBS include:
- Gastrointestinal Motility Issues: In those with IBS, the intestines might either contract too quickly or too slowly, leading to diarrhea or constipation, respectively. Sometimes, infectious gastroenteritis can cause long-term damage to nerves in the gut (called the migratory motor complex). If needed, we can refer patients to a gastroenterologist for a Gastric Emptying Test for an official diagnosis. If the patient’s history or testing leads us to believe motility is an issue, we can use certain herbs and/or medications to treat it.
- Nervous System Abnormalities: An over-sensitive nervous system can heighten pain signals from the intestines, causing discomfort. If a patient suffers from high levels of stress and anxiety and is not having meals in a calm environment, it’s likely that over-stimulation of the nervous system is contributing to their symptoms.
- Post-Infection Changes: Some individuals develop IBS symptoms after suffering from a severe bout of diarrhea caused by bacteria or viruses. When antibiotics are used to fight infection, they can kill good bacteria, causing an imbalance and leading to a leaky gut. I always talk to patients about recent infections and pharmaceutical treatments they’ve used to determine if this is an issue in play.
- Allergies: Food sensitivities and allergies are among the most common triggers for IBS. This frequently includes lactose intolerance and gluten allergies. Some of my patients don’t know for sure if they have food allergies, so we have multiple ways to test for these. Unfortunately, food allergy panels aren’t always reliable, so one of the most effective methods we’ve found is by having patients try an elimination diet to identify triggers.
- Excessive Caffeine, Alcohol, and/or Sugar: Consuming too much of these can contribute to problems such as yeast infection, cortisol excess, and abdominal pain. Reducing or eliminating intake of all 3 of these substances is one of the first steps I take to help my patients experience fast relief.
Who Is at Risk for IBS?
IBS can develop at any age, but symptoms usually present during teenage years and early adulthood. In addition, women are twice as likely to experience IBS than men (most of my IBS patients are women).
IBS often occurs in individuals with other health problems, such as fibromyalgia, GERD, anxiety, and depression.
Causes of IBD
Like IBS, the exact cause of IBD is hard to pinpoint. Studies suggest that a combination of your genes, immune system, and environmental factors are what cause IBD.
Some potential causes and risk factors include:
- Autoimmune Response: In individuals with IBD, the body’s immune system mistakenly starts attacking cells in the gastrointestinal tract, leading to inflammation. This abnormal immune response could be triggered by microbes in the small and large intestines. I run multiple tests to identify any existing autoimmune responses that may be triggering IBD in my patients.
- Genetic Predisposition: Several genes have been linked to IBD, and individuals with a family history are at a higher risk of developing the condition. This typically comes up during my family history with a patient, but in some cases, I may encourage genetic testing to be sure.
- Environmental Triggers: Factors such as poor diet or dietary changes, infections, or even smoking have been suggested to either trigger or exacerbate IBD in genetically predisposed individuals. I discuss these with patients when I take a history.
- Gut Microbiota: An imbalance in the healthy bacteria present in the intestines might play a role in initiating or maintaining the inflammation characteristic of IBD. There are several tests I and other PrimeHealth providers use to identify dysbiosis in the microbiome, such as a Comprehensive Stool Analysis, SIBO (small intestinal bacterial overgrowth) breath testing, and Organic Acid testing. These issues can often be addressed by a dysbiosis diet.
Who Is at Risk for IBD?
A 2015 study on IBS risk factors shows that a Western lifestyle has been attributed to a higher incidence of IBD.
This research notes that migrants from low-prevalence regions to high-prevalence regions have an increased risk of developing IBD. In other words, moving to a location with a larger incidence of IBS increases your chances of developing the condition.
This disease can occur at any age, but the symptoms frequently begin during late teenage years into adulthood.
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Diagnosing IBS and IBD
IBD can cause serious problems if it is left unaddressed. When untreated, it can cause bowel perforations, fistulas, and anal abscesses, and be the precursor to colon cancer. Accurate diagnosis between IBS and IBD is important, as they require different approaches to treatment and management.
To diagnose IBS or IBD, your healthcare provider will:
- Take a comprehensive medical history, asking you about your symptoms, symptom duration, and any triggers you’ve noticed exacerbate your concerns
- Perform a physical exam to pinpoint signs of abdominal bloating, tenderness, or other related issues
- Perform or prescribe additional procedures and tests
Procedures like a colonoscopy or endoscopy allow physicians to visually inspect the large and small intestines and possibly retrieve tissue samples for biopsy.
Blood tests can identify markers of inflammation or anemia, while stool tests can check for infections or blood. Breath testing for SIBO, small intestinal bacterial overgrowth, is one of the ways we test for IBS at PrimeHealth.
In some instances, CT scans or other imaging modalities can provide detailed views of the GI tract for a better diagnosis.
I typically begin with a medical history and physical exam to determine which tests, if any, are worth the investment for each patient. There are several tests we rule out based on a patient’s specific symptoms and unique situation, ensuring that we only prescribe what’s necessary.
Treatment Options
An accurate diagnosis will help your healthcare providers develop the proper treatment plan. Treatment options range from lifestyle changes to surgical interventions (for extreme cases of IBD).
Many IBS treatments can also be used in treating IBD. Reducing stress and making healthier lifestyle changes, including exercising and therapy, are sometimes enough to reverse mild cases of both IBS and IBD.
I and the other providers at PrimeHealth can help with your IBS by identifying and treating the underlying cause, providing an integrative approach to your condition. Conventional gastroenterology can over-rely on medications that mask symptoms in your gastrointestinal tract instead of actually addressing the root problem.
What are the treatment options for IBD? There are various approaches to treating IBD. They include:
- Anti-inflammatory medications: This treatment option for ulcerative colitis and other forms of IBD is usually one of the first conventional doctors try. Drugs like aminosalicylates can help reduce inflammation in the colon.
- Immunomodulators: Immunosuppressants regulate or moderate the body’s immune response, thereby decreasing the inflammation in the intestines.
- Antidepressants: By reducing sensitivity to pain and regulating body functions like digestion, antidepressants can help treat IBS. However, I rarely prescribe these medications as they are difficult to stop taking and have a very high risk of serious side effects.
- Biologics: Medications that neutralize proteins and target specific parts of the immune system to reduce inflammation.
- Surgery: In instances where medication doesn’t achieve desired outcomes or complications arise, surgical procedures to remove affected parts of the digestive tract might be necessary.
- Dietary management: The Autoimmune Paleo Diet was shown in a study from 2017 to improve symptoms and endoscopic inflammation in patients with IBD. The low FODMAP diet can help some patients manage their symptoms and reduce the frequency of flare-ups. This short-term diet curbs fermentable carbs that trigger bloating and other digestive issues.
When it comes to IBS treatment, there is no one-size-fits-all approach. A tailored plan from health experts like our team at PrimeHealth integrative clinic in Denver, Colorado, will help you find relief and reverse your symptoms.
We use a combination of dietary changes, stress relief, exercise, medications, peptides, and supplements to address the root cause of your IBS.
When to Seek Medical Help
Both IBS and IBD can disrupt and decrease your quality of life. If you experience persistent gastrointestinal symptoms, unexplained weight loss, or blood in your stool, it’s time to seek medical attention. You may also want to talk to a provider if you experience consistent fatigue, joint pain, or a family history of IBS or IBD.
If you are in the Denver, Colorado area and ready to begin the journey toward IBS relief, schedule a free consultation with PrimeHealth. Our providers book just 3% of the number of patients that a traditional doctor does, giving you plenty of one-on-one time to address your concerns.
Sources
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- Chey, W. D., Kurlander, J., & Eswaran, S. (2015). Irritable bowel syndrome: a clinical review. Jama, 313(9), 949-958.
- Ye, Y., Pang, Z., Chen, W., Ju, S., & Zhou, C. (2015). The epidemiology and risk factors of inflammatory bowel disease. International journal of clinical and experimental medicine, 8(12), 22529.
- Konijeti, G. G., Kim, N., Lewis, J. D., Groven, S., Chandrasekaran, A., Grandhe, S., … & Torkamani, A. (2017). Efficacy of the autoimmune protocol diet for inflammatory bowel disease. Inflammatory bowel diseases, 23(11), 2054-2060.
