Introduction
Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are the most commonly misunderstood gastrointestinal diseases. Irritable bowel syndrome is noninflammatory, whereas inflammatory bowel disease is chronic intestinal inflammation. Even though IBS and IBD are different, a person diagnosed with one condition may also show symptoms of the other. They can be seen in any age group and can also be familial.
What Is Inflammatory Bowel Disease?
Inflammatory bowel disease (IBD) is a group of diseases distinguished by chronic inflammation in various parts of the digestive system. The conditions classified as Inflammatory bowel disease include Crohn's disease and ulcerative colitis. Ulcerative colitis is the most popular form of IBD.
-
Ulcerative Colitis - In this condition, inflammation occurs recurrently in the colon's mucosal layer. It involves the rectum area and extends to other parts of the colon.
-
Crohn's Disease - This condition affects the gastrointestinal tract beginning from the mouth to the anus. Symptoms include abdominal cramps, fever, and diarrhea.
Another form of IBD is indeterminate colitis. It is used when a confirmatory diagnosis of ulcerative colitis or Crohn's disease is not made during colonoscopy, colonic biopsies, or colectomy.
What Is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a chronic disease of the gastrointestinal tract consisting of symptoms like altered bowel habits and chronic abdominal pain. IBS has no major clinical signs and usually has normal test results. Some causes of IBS include stress, bacterial overgrowth, reactions from previous infections, and food intolerances like lactose, fructose, gluten, or sucrose. Depending on their symptoms. IBS can be classified into:
-
IBS with symptoms of diarrhea (IBS- D).
-
IBS with symptoms of constipation (IBS-C).
-
IBS with mixed symptoms (IBS-M).
What Causes Irritable Bowel Syndrome and Inflammatory Bowel Disease?
Causes Of IBD - A weak immune system is more prone to symptoms of IBD, and IBD can also cause a weak immune system. Normal cases and immune systems protect the body from the effects of dangerous environmental toxins, bacteria, or viruses. But in cases of IBD, the immune system fails and inflammation occurs in the gastrointestinal tract. IBD also arises from a combination of factors such as genetics, gut microbiota, or microorganism living inside the body and environmental factors like stress.
Causes Of IBS - The following conditions increase the risk of IBS in patients. They include:
-
Food intolerance or sensitivity.
-
Bacterial infections of the colon or intestine.
-
Mood disorders like anxiety and depression.
-
Genetics.
How Are the Symptoms of Irritable Bowel Syndrome and Inflammatory Bowel Disease Different?
Symptoms of both conditions tend to overlap, making the diagnosis difficult. IBS consists of symptoms like diarrhea, constipation, abdominal bloating, urgent bowel movements, abdominal pain, abdominal cramps, feeling incomplete evacuation, and bacterial overgrowth in the small intestine area.
IBD causes the symptoms of IBS along with eye inflammation:
-
Extreme fatigue.
-
Joint pain.
-
Intestinal scarring.
-
Malnutrition.
-
Rectal bleeding
-
Weight loss.
Where Do Pain Symptoms Occur In IBD and IBS?
-
IBS Pain - Abdominal pain is a common symptom that occurs continuously or frequently. Pain is usually felt in the lower abdominal area, even though it can occur elsewhere in the belly area. The severity and type of pain can vary even within a day difference. The location of IBS pain can be either:
-
Upper Abdominal Area - The pain in this area can worsen after eating food and is accompanied by abdominal bloating.
-
Middle Abdominal Area - The pain is centered in the abdomen and is often cramping.
-
Lower Abdominal Area - The pain in this usually decreases after bowel movements.
People with IBS experience other pain types like aching, sharp stabbing, cramping, and throbbing. The pain usually includes visceral pain originating from the body organs and functional pain with no bodily source. Since the symptoms of IBS involve functional pain, it is classified as centralized sensitivity syndrome (CSS). These syndromes involve chronic fatigue syndrome and increased pain sensations like fibromyalgia.
-
IBD Pain - People with IBD report abdominal pain when their symptoms initially started and when the disease is active. Several other pain associated with IBD includes oral sores, eye discomfort, skin sensitivity, pain in the joints, and pain around the rectum.
What Are the Complications Seen In IBS and IBD?
If IBD and IBS are left untreated, it can lead to several complications. In addition, both these conditions affect the gastrointestinal tract and a person's mental health.
-
Complications Seen in IBS - IBS leads to a low quality of life, and the person affected by this condition tends to feel inactive. They feel reluctant to engage in activities due to fear of pain or any comfortable side effects arising at an inconvenient time. It can cause several other complications like mood disorders (anxiety and depression), frequent abdominal cramps or bowel movements, which can disrupt a person's daily activities, and chronic diarrhea that can lead to hemorrhoids.
-
Complications Seen in IBD - Since IBD consists of ulcerative colitis and Crohn's disease, the complications in both conditions vary. The complications in ulcerative colitis include severe diarrhea, rectal pain, bleeding, a rapid increase in the colon called a toxic megacolon, and perforated bowel (chronic inflammation causing a hole in the bowel).
The complications of Crohn's disease include malabsorption of food leading to malnutrition, abscess, fistula (connections that form between body parts or tissue and which have to be managed to avoid potential infection), strictures (intestine blockages), and perforated bowels.
How Are IBS and IBD Diagnosed?
IBS and IBD are diagnosed differently. IBD is diagnosed through various tests, and IBS mainly by ruling out other conditions or diseases.
-
Diagnosis Of IBS - A healthcare practitioner makes a diagnosis by taking a detailed medical history, family history, report of symptoms, and a detailed physical examination. The doctor will enquire whether the person had symptoms for at least a day in a week or the last three months and whether the symptoms started at least six months prior. The confirmatory diagnosis is made only after ruling out other diseases or conditions; the diagnosis takes weeks and sometimes even months.
-
Diagnosis Of IBD - Medical tests like blood tests, stool studies, biopsy, and imaging tests like X-rays and magnetic resonance imaging (MRI) to diagnose the condition and to rule out any other existing medical condition.
How Does the Treatment Vary For IBS and IBD?
Treatments for both conditions vary and also depend on their severity. However, the treatment for IBD is usually more complex, whereas IBS can be managed by appropriate lifestyle modification and avoiding triggers that cause the symptoms.
-
Managing IBS - Medical intervention includes medications like Hyoscyamine or Dicyclomine (intestinal antispasmodics). Dietary and lifestyle modifications like avoiding fatty, fried foods and caffeine beverages, relaxation methods like meditation and yoga, psychotherapy to reduce stress, acupuncture, and probiotics.
-
Managing IBD - The primary treatment of IBD includes managing intestinal inflammation to avoid damage to the intestine. Common treatment options include corticosteroids, immunomodulators, surgery, and dietary modifications to avoid food that trigger the symptoms. The treatment for IBD is usually complex, and gastroenterologists work with the patient to create an appropriate treatment plan according to their symptoms.
Conclusion
Inflammatory bowel disease and irritable bowel syndrome are chronic conditions with similar symptoms like changes in bowel movements and abdominal pain. These symptoms alternate between remission and flare-ups. Both these treatments have different causes, diagnoses, and treatment protocols. Since both of these conditions do not have a definitive cure, the treatment primarily focuses on managing the symptoms. IBD is managed by medical interventions, whereas IBS focuses on lifestyle modifications and dietary changes.
