Is it IBS or IBD?
The conditions sound and often act similar, but are quite different.
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Do you have constant pain in your stomach and bloating? Do you often find excuses to avoid going out to eat with friends and family for fear of how your stomach will react?
Could it be irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD)? You may have heard of these conditions if you have stomach or colon problems. They’re similar in that both cause stomach pain, abdominal cramping, bloating, diarrhea or constipation, and can be tricky to diagnose. But they have distinct differences, as well.
How IBS and IBD are diagnosed
At times called “spastic colon,” IBS is a chronic disorder that affects the stomach and intestines, and the condition is commonly seen by primary care physicians and gastroenterologists. Symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation or both.
Sometimes, a person may be initially diagnosed with IBS, but it’s later determined through a colonoscopy or endoscopy (exams that view the colon and gastrointestinal tract) and other imaging studies that they actually have IBD.
“IBD is more concerning because it’s a serious disease of the gastrointestinal tract,” said Patricia McFall Calhoun, MD, FAAFP, a family physician with Baptist Primary Care. “It can take a while to diagnose. If your symptoms aren’t improving, it’s important to be diligent and follow up with your physician for further testing or referral to a gastroenterologist.”
IBD includes two very serious GI conditions: Crohn’s disease and ulcerative colitis. Both result in chronic inflammation of the gastrointestinal tract and can cause tissue damage. Crohn’s often affects different areas throughout the intestinal tract while ulcerative colitis is generally found in the large intestine and rectum.
As of 2023, about 2 to 3 million adults in the U.S. were estimated to have IBD, with over 50,000 new cases being diagnosed each year.
Symptoms of IBD
Some symptoms people should watch out for with IBD, include:
- Persistent diarrhea
- Bloody or black stools
- Weight loss or diminished appetite
- Abnormal laboratory testing
- Symptoms worsen at nighttime or over time
IBD requires ongoing treatment and monitoring. Severe cases may also require surgery.
“IBD is definitely more concerning because it increases the risk for colon cancer,” Dr. Calhoun said, adding that she will generally obtain a medical history, perform a clinical exam and order blood work and stool tests to help in the diagnosis.
Managing IBS
Irritable bowel syndrome can often be managed with simple diet adjustments, including:
- Trying an elimination diet to determine if specific foods aggravate symptoms.
- Going lactose free to see if it helps reduce gas.
- Trying gluten-free products.
- Consuming adequate dietary fiber and taking fiber supplements, if necessary.
- Considering probiotics, although evidence for benefit is inconclusive.
- Seeing your physician to consider prescription treatments if conservative measures don’t provide relief.
“A heart-healthy diet with regular exercise and adequate sleep are vital components to disease prevention and continued wellness,” Dr. Calhoun said. “Inadequate sleep can also cause you to experience more stress, which can definitely aggravate IBS symptoms.”
Stress, anxiety and depression can contribute to IBS, so optimizing not only physical but also mental health is important for GI health. Your doctor may also prescribe muscle relaxants or other medications to reduce intestinal spasms and alleviate IBS symptoms.
“These conditions can impact a person’s ability to eat outside of their home or perform their regular routines because of a constant fear that their GI symptoms may flare up at any time,” Dr. Calhoun said. “Both IBS and IBD can be distracting because people are worried about what their stomach is doing instead of attending to what they need to at the time. Patients can feel nervous and embarrassed as they constantly look for or have to run to the bathroom. Seek medical evaluation if these GI symptoms are interfering with your activities or wellness.”
Not sure if it's IBD or IBS?
Contacting your primary care doctor is an important first step towards a diagnosis. To learn more about services from Baptist Primary Care, call 904.202.4YOU (4968) or fill out the appointment request form.
