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IBD vs. IBS: What’s the difference?


IBD vs. IBS: What’s the difference?

If you regularly experience gastrointestinal symptoms, such as diarrhea, abdominal pain or the sudden urge to use the bathroom, you know how much they can impact your day-to-day life.

Dr. Christopher Bach, a gastroenterologist at Tidelands Health Gastroenterology at The Market Common and Murrells Inlet, sees a lot of patients with gastrointestinal conditions.

“There’s definitely an element of education that comes with treating patients for gastrointestinal problems,” says Dr. Bach, medical director of digestive health at Tidelands Health. “There’s a lot going on in that part of the body, and a lot of confusing acronyms to describe it.”

For example, it’s easy to confuse irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The conditions have similar symptoms, although the causes are quite different.

“Untreated, both IBS and IBD can really lower your quality of life,” Dr. Bach says. “It’s important to work with a care provider to find the best treatment plan for you.”

Here’s how to tell the difference between the two types of illnesses, and what types of treatment your physician might suggest:

Irritable bowel syndrome

Irritable bowel syndrome, or IBS, is a disorder that causes abdominal discomfort or pain related to bowel movements. The pain is often accompanied by diarrhea, constipation or both, depending on the subtype.

IBS affects up to 15 percent of people in the U.S., according to the American College of Gastroenterology. Women are twice as likely to be affected.

“Unlike inflammatory bowel disease, in IBS cases, the gastrointestinal tract often looks normal in screenings,” Bach says. “Your care provider will likely ask questions about your symptoms and lifestyle or order tests to rule out other causes.”

Symptoms are caused by abnormal muscle contractions in the intestine, problems with nerves or, in some cases, by severe infections. Stress and changes in gut microbiota can also play a role.

Lifestyle changes are the first line of defense in IBS cases, especially in mild cases. In general, it’s a good idea to avoid foods that trigger symptoms, eat foods that are high in fiber, drink plenty of fluids, exercise regularly and get good sleep.

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Physicians may recommend cutting out foods and drinks that cause bloating, have gluten or contain FODMAPs, which are carbohydrates that can irritate your gastrointestinal tract. The good news is people with IBS are not at an increased risk for developing colon cancer.

In more severe cases, physicians may prescribe medications to treat symptoms, such as fiber supplements, laxatives or antidiarrheals. Additionally, there are medications that specifically treat IBS by influencing muscles or fluid secretions in your intestines to regulate digestion.

“Treating IBS can take trial and error,” Bach says. “Having a good relationship with your care provider and communicating openly will be a big help.”

Inflammatory bowel disease

Inflammatory bowel disease, or IBD, is a term given to specific autoimmune diseases – Crohn’s disease and ulcerative colitis – that can cause chronic inflammation, irritation and ulcers throughout the gastrointestinal tract. Crohn’s disease can affect any portion of the gastrointestinal tract from the mouth to the anus, while ulcerative colitis affects parts of the colon from the large intestine to the anus.

Unlike IBS, symptoms of IBD are evident through screenings, including blood work and endoscopy. The ulcers and inflammation can damage the lining of the colon, which can result in bloody and loose stools and can permanently damage the gastrointestinal tract. Patients with inflammatory bowel disease are at an increased risk for developing colon cancer.

“The goal of treatment is to reduce inflammation before it triggers any symptoms or does permanent damage,” Bach says. “The best-case scenario is that treatment, either through medication or surgery, results in long-term remission, restoring the patient’s quality of life.”

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In terms of medication, physicians may recommend immunosuppressants to weaken the immune system or corticosteroids to control inflammation.

Lifestyle changes, such as eating a low-fiber or low-FODMAP diet, drinking lots of water and avoiding triggers, may also help.

“Your diet doesn’t cause inflammatory bowel disease, but it might help you manage symptoms during flare-ups,” Dr. Bach says. “For those with these chronic conditions, it can be tricky to see which foods you can tolerate and which ones you can’t, and triggers can change throughout the course of the disease.”

In cases where medications and other treatments aren’t helping, surgery may be necessary.

In severe IBD cases, a surgeon may need to remove the damaged portion of the digestive tract, sometimes the entire large intestine and rectum.

“If you are having any type of GI issue, especially if you have blood in your stools, make an appointment with your physician,” Dr. Bach says. “There are tests and treatments available to help you feel better.”

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