IBS vs IBD - what are the differences?

IBD and IBS are both digestive conditions that can cause some pretty severe gastrointestinal symptoms. First let’s take a look at some definitions:

  1. IBD - inflammatory bowel disease; comprised of three different but related diseases that involve differing levels of inflammation found in the small or large intestine; types: Crohn’s, Ulcerative Colitis, Microscopic colitis. Can occur anywhere from mouth to anus (primarily Crohn’s disease). Can be exacerbated by stress, illness, changes in temperature; can also be accompanied by other autoimmune conditions.

  2. IBS - Irritable bowel syndrome, a diagnosis of a functional disorder/set of symptoms that involves any change in bowel frequency or stool texture that fits the diagnosis requirements. Occurs within the intestines, but appears to be complex gastrointestinal-neurological disorder worsened by stress,

  3. disease - “a disorder of structure or function in a human, animal, or plant, especially one that has a known cause and a distinctive group of symptoms, signs, or anatomical changes”

  4. syndrome - “a condition characterized by a set of associated symptoms”

They have a lot in common, but there is more that separates these conditions than one might realize at first. Lets look at the commonalities first.

Similarities

Both are characterized by diarrhea or constipation or both, as well as a laundry list of other complaints, such as:

  • bloating,

  • abdominal pain and cramping

  • nausea

  • reflux

  • bowel urgency

  • straining

  • fatigue

Another commonality they share are food fears. Meaning, because of the above listed symptoms, we develop a negative association with food that can keep us from eating any food we perceive as unhealthy, difficult to digest, symptomatic, or even out favorite staple foods. This phenomenon is not only associated with IBS and IBD, but a multitude of other chronic or long-term conditions.

That is pretty much where the similarities end. Both conditions are characterized by mild to severe (IBS) or moderate to severe (IBD) digestive symptoms that negatively impact quality of life and, often, food tolerance. IBD is classified as a disease and IBS is classified as a functional syndrome. Unfortunately, we don’t really know what causes either condition, but scientists are starting to formulate some theories on each. We also know that stress, changes in routine, and large alterations in diet/lifestyle can worsen either condition.

Differences

Let’s look at some of the differences.

IBS

  • a functional disorder (defined as: a recognizable medical condition whose symptoms are due to changes primarily to the functioning of the systems of the body, rather than due to a definable disease affecting the structure of the body”

  • superficial changes to the intestines rather than penetrating changes

  • no direct long-term consequences (does not mean there aren’t consequences, they are due to changes in dietary patterns and lifestyle rather than a disease process itself)

  • can be transient, not always lifelong

  • diagnosis of symptoms rather than histology or pathology

  • primarily treated through lifestyle changes along with minor dietary changes, though there are some immerging medications that seem to help

IBD

  • a disease characterized by inflammation brought about by an autoimmune (body attacking itself) process where there is either full wall thickness inflammation (crohns) or lining thickness inflammation (UC).

  • there are changes to the intestines on a histogical (cellular) level

  • can cause permanent changes to the intestines, especially with stricturing or fistulizing disease or need to surgically excision

  • can cause major nutrient deficiencies directly, including: zinc, B12, iron. B12 and iron are often infused or injected in persons with IBD

  • can go into remission but is a lifelong disease with no known cure

  • is an autoimmune, autoinflammatory condition that generally requres medication to treat

  • medications to treat IBD can also cause permanent side effects

  • most people benefit from some type of nutrition and lifestyle modification

Treatment Options

There are many treatment options available to individuals with IBS and/or IBD (oh yes, they can cooccur). Primarily, with IBS, we start with lifestyle changes including stress management to help treat the neurological component, as well as some testing to determine what gastrointestinal pieces are contributing to the symptom picture. Then we target dietary changes. With IBD, this often looks like a medication first approach, though not always if disease is moderate and symptoms are manageable. We often look to replete (reload) micronutrients, fiber, and protein and change the textures of food. We also work on stress management - as high stress exacerbates all inflammatory processes. Then we refer out to make sure there are not any other emerging autoimmune diseases as of yet and target your trigger and inflammatory foods.

Next Steps

Seek out a dietitian in your area who focuses on or specializes in digestive disorders, particularly crohns or colitis if you have or strongly suspect an IBD diagnosis. DO NOT get overwhelmed by overgoogling your symptoms, or a diet for this or that. Dietary approaches may be similar for all with a specific condition, but they are not universal - reach out and ask for personalized help.

If you would like to work with myself at Kokua Lifestyle and Nutrition, hit that appointment button or send me an email.