What is the difference between IBS and IBD?

What is the difference between IBS and IBD? Do you know?

You should do! Whilst these two conditions sound similar in name, they are very different. It is good to have an understanding of the difference to make sure your condition is managed safely.

In this post I will outline the difference between IBS and IBD. I will also explain how IBD is diagnosed and managed.

What Is IBS?

Irritable bowel syndrome (IBS) is a functional bowel disorder (1). This means that the gut does not function correctly.

You may be surprised to know that IBS is quite a common condition with 1 in 10 people thought to be affected (2).

The symptoms of IBS include stomach pain or discomfort with a change in bowel habit. If you have IBS, then you may suffer with constipation, loose stools or a mixture of both.

Researchers are not entire sure what causes IBS but it is thought that genetics, infection and stress are linked (2, 3).

There is sadly no known cure for IBS. However, treatments such as the low FODMAP diet, probiotics and fibre manipulations have been shown to help manage symptoms (4, 5).

What Is IBD?

Inflammatory bowel disease is an umbrella term used to describe two conditions: Chron’s disease and Ulcerative Colitis.

Chron’s disease: this condition is caused when your body wrongly see’s harmless bacteria as a threat. This results in an immune response and inflammation anywhere in your GI tract (6).

Ulcerative colitis: if you have ulcerative colitis then this is similar to Chron’s. The difference being that only your colon is affected and ulcers are formed (7).

If you have IBD, you will go through phases of remission and active disease. During a remission your bowel will not be inflamed.

There is sadly no cure for IBD. However, the correct medications and a healthier lifestyle can help to keep in you in remission.

What Are the Symptoms of IBD?

The symptoms of IBD vary from person to person. Many of the symptoms are similar to IBS and this is why you can not rely on symptom history alone to diagnose these conditions.

Typical IBD symptoms you may find include (8);

• Stomach pain
• Blood in stools
• Mucous in stools
• Diarrhoea
• Weight loss
• Anaemia

IBS vs IBD

Fact	IBS	IBD
Affects the gastrointestinal tract	Yes	Yes
Functional bowel disorder	Yes	No
Inflammatory bowel disorder	No	Yes
Life-long condition	Yes	Yes
Blood in stools	No	Yes
Causes of nutritional deficiencies	No	Yes
Causes of weight loss	No	Yes

Why Do I have IBD?

Researchers do not yet know for certain why some people get inflammatory bowel disease. There are have been many studies trying to look for links.

The following areas have be found to be linked (9, 10);

• Low vitamin D levels
• Impaired sleep
• Dietary fibre
• Saturated fats
• Depression
• Air pollution
• Breast feeding
• Antibiotic exposure
• Alteration in gut bacteria levels
• Genetics

How Do you Get Diagnosed with IBS vs IBD?

As you know, it is really important to get a formal diagnosis if you are having any digestive symptoms.

Diagnosing IBD and IBS actually start off in the same way.

Firstly, you need to visit your family medicine doctor (GP) who will run some routine checks and take a history. You can read about this here. 

If any of your tests come back positive at this stage your doctor will refer you to a GI specialist.

To get an IBD diagnosis you will require a colonoscopy.

Which Diets Are Best For IBD?

Which diet you need to follow will depend on what stage you are at.

If you are in remission then you will just need to follow a general healthy diet. There is no need for a ‘special diet’ at this stage.

If you are having an IBD flare up, then you have a couple of dietary options;

1. A fortified diet to ensure you are meeting your nutritional requirements. When you are having an IBD flare up, both you calorie and protein requirements increase.
2. An elemental diet (for Chron’s Disease). This diet is a liquid diet which is broken down into small particles that are easy for your gut to digest.

The evidence isn’t clear as to how affective elemental diets actually are so I would suggest you allow your dietitian to assess you and weigh out the risks vs benefits (11, 12).

Also note that during a flare up your protein requirements will increase. You should aim for around 1.2-1.5g / kg / day of protein (12).

You may need additional calcium supplements. There is an increased risk of osteoporosis in those who have IBD. Speak to your dietitian for specific guidance on this (12).

When you have IBD your bowel is not able to absorb all nutrients affectively. Therefore, it is advertised that you have your micronutrient levels such as vitamin D and iron checked regularly (12).

If you are struggling with your appetite or have noticed unplanned weight loss, please tell your doctor or dietitian ASAP.

Will The low FODMAP Diet Help My IBD?

The low FODMAP diet is a diet which is low in fermentable carbohydrates. This diet is normally used for people with IBS.

Interestingly, this diet also works for those with IBD!

Research has shown that in those in remission or mild to moderate disease, the low FODMAP diet reduces symptoms (13).

Just be careful that you only stay on the diet for a maximum of 6 weeks before introducing. You should also note that is not useful if you are in an acute flare up phase.

Can You Have IBS and IBD?

Sadly, having one of these conditions does not exclude you from being able to have the other.

You may even be at a higher risk of having IBS if you gut has become disrupted as a result of IBD.

Often my clients find that even when they are in remission with IBD, they still have symptoms. The symptoms are caused by IBS and this is what we go on to manage.

Summary

Whilst some of the symptoms of IBS and IBD and similar, the conditions are entirely different.

It is important to get an accurate diagnosis so your condition can be treated affectively.

Diet plays a huge role in both IBD and IBD. Sometimes dietary changes are complicated and you will need the help of a registered dietitian to aid you.