Do I Have IBS or IBD? How to Tell

Updated by: Julia Zakrzewski

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) may sound similar and can even share some of the same symptoms, but they are two very different digestive conditions.

While both can significantly affect your daily life, IBD can cause much more serious complications and require different treatments.

IBD is characterized by inflammation that can cause permanent damage to your intestinal wall. 

Alternatively,  IBS is a functional disorder that can cause uncomfortable symptoms, but it shouldn’t cause permanent damage to your digestive tract.

Understanding the key differences can help you get the proper diagnosis and treatment plan.

This article will share key features of both IBS and IBD, how to tell the difference between them, and what treatment looks like for each. 

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What is Irritable Bowel Syndrome (IBS)?

Irritable bowel syndrome (IBS) is a functional GI disorder, which means the function of the digestive tract is not working as it should.

It affects around 10% of the population and is more common in women than men. 

The causes of IBS aren't entirely understood but may include a history of food poisoning, stress, and motility dysfunction (how food moves through the intestines). 

People with IBS often have visceral hypersensitivity, which means the nerves in the GI tract are more reactive and easily 'triggered' by food, stress, inflammation, or other environmental factors. 

The gut-brain connection is also considered an essential factor in IBS, where the close relationship between the brain and the digestive system can cause emotional and physical symptoms. 

There are four types of IBS, all related to bowel movements: 

1. IBS with constipation (IBS-C)
2. IBS with diarrhea (IBS-D)
3. Mixed IBS (IBS-M)
4. Unspecified IBS, which means stool consistency doesn't fall into an expected pattern (IBS-U)

Even though IBS doesn't cause structural damage to the digestive tract, it can still significantly impact your quality of life.

Frequent trips to the bathroom, painful bloating or cramping, and an inability to enjoy their favorite foods can leave people feeling frustrated and anxious.

What is Inflammatory Bowel Disease (IBD)?

Inflammatory bowel disease (IBD) is a group of digestive disorders that cause inflammation of the intestines affecting over three million Americans.

IBD can be broken down into two categories: Ulcerative colitis and Crohn's disease.

Both disorders are characterized by chronic inflammation of the digestive tract, but each has different symptoms and treatments depending on the severity of the disease. 

Ulcerative Colitis

Ulcerative colitis causes inflammation in the lining of your large intestine and rectum.

Symptoms can include abdominal pain, bloody diarrhea, and fatigue. 

We created a free meal plan for ulcerative colitis—try it now. 

Crohn’s Disease

Crohn's disease is a type of IBD that affects any part of the digestive tract, from the mouth to the anus.

Symptoms include abdominal pain, weight loss, diarrhea, and fatigue. 

What Causes IBD

The causes of IBD are once again complex. Researchers believe genetic, immune, and environmental factors are to blame. 

If left untreated, the inflammation can spread and cause serious health complications, including damage to the intestines, but the good news is that it can be effectively managed with proper treatment.

How Is IBS Different Than IBD?

The primary difference between IBS and IBD is that IBS is functional, while IBD is structural.

While IBD is a chronic inflammatory disease that can cause damage to the gut structures, IBS is a digestive disorder that causes symptoms without tissue damage. 

IBD also involves an autoimmune response, which means your body's immune system is attacking its own cells.

IBS may involve the immune system that causes intestinal inflammation, but it's not the same as the autoimmune response seen in IBD.

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Symptoms of IBS and IBD

At first glance, the symptoms of IBS and IBD look very similar. Irregular bowel habits and food sensitivities can both occur with IBS and IBD. 

Other symptoms of IBS and IBD that overlap can include:

• Abdominal pain.
• Constipation. 
• Diarrhea.
• Bloating.
• Nausea.

However, IBD can also cause more serious symptoms, including:

• Weight loss.
• Bleeding.
• Mouth sores.
• Eye inflammation.
• Painful joints.
• Fever.
• Anemia.
• Nutrient deficiencies.

What are the Causes of IBS and IBD

Researchers continue to investigate the causes of IBS and IBD. 

Some people develop IBS after having a GI infection.

Other causes can include diet, frequent use of antibiotics, small intestinal bacterial overgrowth, changes to their environment, or psychological factors like stress and anxiety. 

IBD is an autoimmune condition that can be caused by genetics and environmental factors.

It’s also believed that psychological factors like stress can contribute to painful flare ups. 

Diagnosing IBS and IBD

Anytime you have changes in your bowel habits or abdominal pain, it's important to see a medical professional, such as your primary care physician or a gastroenterologist. 

The diagnosis of both conditions start with a physical examination and a review of your medical history.

Your doctor may also perform laboratory tests to assess your general health and check for anemia, infection, and inflammation. 

Since IBS doesn't appear on tests like X-rays or endoscopy, it's often diagnosed after ruling out other causes of symptoms. 

The Rome IV criteria is used to diagnose IBS, and it states that someone must experience recurrent abdominal pain at least once a week in the last three months associated with at least 2 of the following for diagnosis:

• Pain related to bowel movements.
• Change in frequency of stool.
• Change in appearance of stool.

‍Inflammatory bowel disease, on the other hand, causes damage to the intestines, so x-rays, biopsies, colonoscopies, stool tests, MRIs, or CT scans may be used to visualize the intestines for diagnosis.

Have IBS symptoms? Take the IBS quiz to understand whether or not you have IBS.

Treating IBS and IBD

Any digestive-related health condition takes a multi-faceted approach and should be individualized to the person.

A combination of medical and lifestyle interventions are usually recommended, including:

Medications 

IBS medications may include those that address symptoms like diarrhea or constipation. 

Not everyone with IBS takes medications, but they may help those with severe symptoms until lifestyle changes can occur. 

IBD medications are different and usually address inflammation and suppress the immune system to limit damage and reduce symptoms.

Nutrition

Better nutrition management may improve symptoms and overall health in both IBS and IBD. 

Many people with IBS experience food sensitivities that can actually improve over time.

Elimination diets may reduce inflammation and expose possible trigger foods. 

Certain foods and supplements can also support the health of the gut bacteria and reduce IBS symptoms.

Similarly, for IBD, nutrition changes may help calm inflammation and remove problematic foods that trigger symptoms or irritate.

Stress reduction and mental health support. 

Stress is a significant factor in IBS and IBD, therefore managing stress levels can be vital for symptom relief.

Some treatment options could include deep breathing, yoga, massage therapy, counseling, or whatever works best for you.

Takeaway

IBS and IBD are different conditions, yet they can be easily confused.

The primary difference is that IBS is a functional syndrome, while IBD is an inflammatory disease. 

A visit with your healthcare provider can help you determine the right diagnosis and ensure you get the best treatment.

How a Dietitian Can Help

If you're struggling to manage gut health and have been unable to find relief, a registered dietitian nutritionist (RD) can help.

An RD is a licensed health professional with the knowledge and expertise to work with you and your healthcare team to create an individualized nutrition plan that meets your needs. 

You may not know what to expect if you’ve never worked with a dietitian before.

Here are some questions you may want to ask: 

• What vitamins can I take for bloating? 
• What can I eat to relieve constipation?
• Should I try an anti-inflammatory diet for IBS?
• What snacks are good for IBS?  

Find a dietitian near you that accepts insurance using Nourish.

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