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What's the difference between IBS and IBD?

IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease) are easy conditions to confuse. As well as having similar names, the two have many similar symptoms - People with these conditions may experience stomach (abdominal) pain, cramps, constipation and diarrhoea, as well as feeling generally unwell.

But the conditions are quite distinct, with different causes and different treatments. If you're experiencing any of these symptoms, it's important to see your doctor who can give you a definite diagnosis.

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How IBS and IBD differ

The main difference between the two is that IBS is classed as a 'functional' disease - where the symptoms lack an identifiable cause - whereas IBD involves some damage to the gut that will be obvious on a physical examination.

"With IBS, there are problems with the way in which the diet, gut nervous system and microbiome interact with the brain and central nervous system," says Dr Simon Smale, a stomach speciailist (gastroenterologist) and trustee at The IBS Network. "People with IBD get episodes of inflammation within the gut, leading to changes you can see using an endoscope. So with IBS, the lining of the bowel looks normal, while with IBD there may be patches which are not right."

The name IBD is an umbrella term for several different conditions, including ulcerative colitis and Crohn's disease. Ulcerative colitis affects the inner lining of the colon and rectum, whereas Crohn's disease can affect any part of the digestive tract.

As well as the digestive symptoms, people with IBD might also experience:

  • Unexplained weight loss.

  • Bleeding from the bottom (rectum).

  • Joint pain.

  • Anaemia.

  • Skin problems.

These symptoms vary from person to person and are likely to be on and off - so you may have flare-ups every so often, with periods of good health in between.

Although IBD can significantly impact your day-to-day functioning, it is not always more serious than IBS. As Dr Smale explains, both are long term (chronic) conditions, which can range from mild to very severe.

"The symptoms of IBS can be as debilitating as the symptoms of IBD, and it can be very difficult for us to tell the difference," he says. "So, it's important that people have tests that help differentiate between the two."

Patient picks for Irritable bowel syndrome

Diagnosis and treatment

When you go to the doctor with IBS symptoms, they may order a series of blood tests to rule out other conditions. Typically, this will include a full blood count, a test for markers in the blood of inflammation, and a test for coeliac disease - another condition that can cause similar symptoms. You may also be asked to carry out a poo (stool) test.

If all these tests do not find anything and you're suffering from typical symptoms, that provides a strong indication you are suffering from IBS. You may be prescribed a medicine like an intestinal antispasmodic, as well as guidance about lifestyle or dietary changes. Generally, self-management is the most effective treatment.

A positive result to a test may require further investigation. If the doctor thinks you may have IBD, you may be referred for an endoscopic procedure such as a colonoscopy - which may involve a biopsy where they test a small piece of your skin. Your doctor may also refer you to a specialist at the hospital for further investigations.

With IBD, treatment is geared towards reducing the inflammation in your bowel. Medicines might include immunosuppressants (which ease the immune response in the gut), steroids - used for short-term treatment during a relapse - and biologic medicines. Some people may eventually need surgery to remove the damaged part of the stomach.

But as IBD and IBS symptoms vary from person to person, so too will treatment. Some will require surgery while others may manage it by recognising the triggers.

Whether your symptoms are mild or severe it is always best to rule out IBD before attempting to self-manage your condition.

Article history

The information on this page is peer reviewed by qualified clinicians.

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