IBD versus IBS

When you enter the world of gastroenterology one of the first things you encounter are a whole host of new acronyms that are thrown about like you know what they are talking about. Don’t be afraid to say WHOA, and ask if you aren’t sure. Two of these that can be confusing and are most certainly confused by the public are IBD and IBS. This confusion can lead to a lot of confusion and misunderstanding as you family and friends often use the terms interchangeably leading them to believe Crohns and colitis are no big deal. (We know different

Different intestinal disorders can produce similar symptoms. Irritable bowel syndrome (IBS) is a condition that produces some symptoms similar to those of inflammatory bowel disease (IBD), but they are not the same condition, and they involve very different treatments. Therefore, getting an accurate diagnosis is essential to managing your condition properly.

Irritable bowel syndrome (IBS) is classified as a functional gastrointestinal disorder, which means there is some type of disturbance in bowel function. It is not a disease, but rather a syndrome, defined as a group of symptoms. These typically include chronic abdominal pain or discomfort and diarrhea, constipation, or alternating bouts of the two. People with IBS are also more likely to have other functional disorders such as fibromyalgia, chronic fatigue syndrome, chronic pelvic pain, and temporomandibular joint (TMJ) disorder.

IBS has been referred to by many names, including mucous colitis and spastic colitis, but these terms are inaccurate and lead to confusion about what IBS is. While the word “colitis” refers to an inflammation of the colon (large intestine), IBS does not cause inflammation. Unlike ulcerative colitis patients, IBS sufferers show no sign of disease or abnormalities when the colon is examined.

IBS does not produce the destructive inflammation found in IBD, so in many respects it is a less serious condition. It doesn’t result in permanent harm to the intestines, intestinal bleeding, or the harmful complications often occurring with IBD. People with IBS are not at higher risk for colon cancer, nor are they more likely to develop IBD or other gastrointestinal diseases. IBS seldom requires hospitalization, and treatment does not usually involve surgery or powerful medications, such as steroids or immunosuppressives.

IBS can, however, cause a great deal of discomfort and distress, and can severely affect an individual’s quality of life. Its symptoms can range from mildly annoying to disabling – impinging on a person’s self-image, social life, and ability to work or travel. People with IBS are more likely to seek health care for both gastrointestinal and non-gastrointestinal complaints compared to people without IBS. It is estimated that IBS results in direct and indirect medical costs of over $20 billion annually.

IBD is a different animal. Its is a disease with a progressive and destructive component. The most common are Crohn’s disease and ulcerative colitis. These are inflammatory bowel diseases that cause chronic inflammation and
damage in the gastrointestinal (GI) tract. The GI tract is responsible for digestion of food,
absorption of nutrients, and elimination of waste.Inflammation impairs the ability of affected GI organs to function properly, leading to symptoms such as persistent diarrhea, abdominal pain, rectal bleeding, weight loss and fatigue.

While ongoing inflammation in the GI tract occurs in both Crohn’s disease and ulcerative colitis, there are important differences between the two diseases. Crohn’s disease can affect any part of the GI tract, from the mouth to the anus. It most commonly affects the end of the small intestine (the ileum) where it joins the beginning of the colon. Crohn’s disease may appear in “patches,” affecting some areas of the GI tract while leaving other sections completely untouched. In Crohn’s disease, the inflammation may extend through
the entire thickness of the bowel wall.

Ulcerative colitis is limited to the large intestine (colon) and the rectum. The inflammation occurs only in the innermost layer of the lining of the intestine. It usually begins in the rectum and lower colon, but may also spread continuously to involve the entire colon.

In some individuals, it is difficult to determine whether their IBD is Crohn’s disease or ulcerative colitis. In these rare cases, people are given the diagnosis of indeterminate colitis (IC).