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IBS is a chronic abdominal pain condition that typically causes constipation, diarrhea, or both. IBD is an umbrella term for the inflammatory conditions Crohn’s disease and ulcerative colitis.

When it comes to the world of gastrointestinal diseases, you may hear a lot of acronyms, such as IBD and IBS.

Inflammatory bowel disease (IBD) is a broad term that refers to chronic inflammation of the intestines. People often confuse IBD with the noninflammatory condition irritable bowel syndrome (IBS).

Although the two disorders share similar names and some of the same symptoms, they have key differences. It’s also possible to have both conditions at the same time.

Read on to learn what distinguishes IBD and IBS.

IBD is a term for a group of disorders characterized by prolonged inflammation in various parts of the digestive tract. The two main conditions under the IBD umbrella are:

  • Ulcerative colitis (UC): UC is a lifelong condition characterized by recurring episodes of inflammation in the mucosal layer of the colon. It always involves the rectum and may extend to other parts of the colon.
  • Crohn’s disease (CD): CD can affect any part of your gastrointestinal (GI) tract, from your mouth to your anus. Symptoms of CD may also include diarrhea, abdominal cramps, and fever.

Doctors diagnose another form of IBD, indeterminate colitis, when tests cannot at first distinguish which form of IBD it is. Most cases of indeterminate colitis eventually evolve to a diagnosis of either CD or UC.

There’s no cure for either CD or UC, but you can manage them with medication.

IBS is a chronic functional disorder of the GI tract characterized by chronic abdominal pain and altered bowel habits. People with IBS show no clinical signs of a disease and often have normal test results.

IBS has physical symptoms, but the causes are not well understood. Researchers are currently looking into potential causes, such as:

  • food intolerances (such as fructose, lactose, sucrose, or gluten)
  • a reaction from a previous infection
  • bacterial overgrowth
  • stress

Depending on the main symptoms, people with IBS receive a diagnosis of one of three classifications:

Prevalence of IBS and IBD

IBS is extremely common. The International Foundation for Functional Gastrointestinal Disorders estimates that it affects between 25 and 45 million people in the United States.

The Centers for Disease Control and Prevention (CDC) estimates that between 2.4 and 3.1 million people in the United States have an IBD diagnosis, and that prevalence is increasing.

Many of the symptoms of these conditions overlap, which can make diagnosis complex.

Symptoms of IBS include:

IBD can cause the same symptoms as IBS, as well as:

If you have symptoms of either IBS, IBD, or both, be sure to discuss your concerns with a doctor or a gastroenterologist.

Abdominal pain is a common symptom of both IBS and IBD. With IBD, you may experience pain in other parts of your body, too.

IBS pain

Abdominal pain is the most common symptom reported by people with IBS. Research shows that 3 out of 4 people with IBS report either continuous or frequent abdominal pain.

The type and severity of pain can vary, even within a single day, and may feel:

  • cramping
  • sharp or stabbing
  • aching
  • throbbing

The pain is usually felt in the lower abdomen, though it can occur anywhere in the belly. Types and locations of IBS pain may include:

  • Upper abdomen pain may worsen after eating and is often accompanied by bloating. However, this is typically associated with other GI issues, like H. pylori or gallbladder problems.
  • Middle abdomen pain centers in the belly area and is often felt as cramping.
  • Lower abdomen pain usually decreases after a bowel movement.

IBD pain

The Crohn’s & Colitis Foundation estimates that 50% to 70% of people with IBD report GI pain.

Pain from CD is most often felt in the lower right abdomen, though it can skip around since the disease affects the entire GI tract. You’re most likely to feel UC pain in the lower left abdomen.

People also report pain associated with IBD in other parts of the body, such as:

  • painful joints
  • skin sensitivity
  • eye discomfort
  • oral sores
  • pain around the rectum

The exact causes of IBS and IBD are still the subject of clinical study. Scientists think genetics and family history play a part in both.

IBS

The cause of IBS is not known for certain, but researchers think the following factors increase your risk:

  • bacterial infections in the intestines or colon
  • food intolerances and sensitivities
  • mood disorders, such as depression and anxiety
  • a family history of IBS

IBD

The exact cause of IBD is unknown. The main trigger is likely an immune system that does not operate as it should. Researchers now think that IBD arises through a combination of:

Typically, the immune system limits the effects of harmful bacteria, viruses, and environmental toxins. In a person with IBD, the immune system falters, and inflammation develops in the GI tract.

Researchers also think genetics play a part in causing IBD. People with a family history of either UC or CD are at greater risk of developing these diseases.

The role of stress in IBS and IBD

Stress can make GI disorders, like IBS, feel worse. In the case of IBD, research shows stress may also affect the onset of the disease and contribute to flare-ups.

Stress reduction techniques may help decrease your IBS symptoms. Consider trying:

The diagnostic processes for IBS and IBD are very different. Diagnosing IBD requires a variety of tests, whereas doctors diagnose IBD largely by ruling out other diseases and conditions.

IBS

Doctors do not order tests to diagnose IBS, although they may use test results to rule out other conditions. Instead, doctors make an IBS diagnosis based on:

  • medical history
  • family history
  • physical exam
  • symptom report
  • ruling out other conditions

For an IBS diagnosis, you must have had symptoms at least 1 day per week over the last 3 months, with symptoms having started at least 6 months ago.

Doctors often only make an IBS diagnosis after ruling out other conditions, so it can be a lengthy process. It may take weeks or months to arrive at an IBS diagnosis.

IBD

Diagnosis of IBD requires medical tests. Doctors may use any of these tests to help diagnose IBD as well as rule out other medical conditions:

Your doctor may also refer you for endoscopic evaluations, such as an esophagogastroscopy or colonoscopy, to evaluate the severity and extent of inflammation. These involve inserting a small tube with a camera into either the esophagus or the rectum.

During these exams, your doctor will likely collect tissue to biopsy to help differentiate between different types of IBD.

Both IBS and IBD can lead to complications, especially if left untreated. These conditions affect not only the digestive system but your mental health as well.

IBS complications

If left untreated, IBS can lead to a lower quality of life. You may miss days of work and feel reluctant to engage in activities for fear that pain or embarrassing side effects might arise at an inconvenient time.

IBS can involve other complications, such as:

  • chronic constipation or diarrhea, which can lead to hemorrhoids
  • frequent bowel movements or cramps that can disrupt daily activities
  • mood disorders such as depression and anxiety

IBD complications

Symptoms of IBD may escalate to conditions that require medical attention. These complications can occur quickly. If they do, you will need to seek immediate medical help.

UC complications might include:

Complications of CD can include:

Complications of IBD can also develop outside the GI tract. For example, disorders may develop in other parts of the body, such as the skin, kidneys, or joints.

Protecting your mental health with IBS or IBD

If you experience any changes in your mood or symptoms of depression, seek help from a doctor or mental health professional. Treatments are available to help you manage your mental health along with your GI symptoms.

Consider the following organizations for resources and support:

Treatments for IBS and IBD vary based on severity. While IBS often responds well to lifestyle changes and avoiding triggers, IBD treatment is typically more complex.

IBS

You may treat IBS with medications such as intestinal antispasmodics, like hyoscyamine (Levsin) or dicyclomine (Bentyl).

Dietary and lifestyle changes that seem to help the most include:

IBD

IBD treatment depends on the form diagnosed. The primary goal is treating and preventing inflammation that, over time, can damage the intestines. Common treatment options for IBD can include:

The first line of treatment for IBD is usually medication. Natural remedies should only supplement your existing treatment plan with your doctor’s permission and supervision, and they may not be effective.

IBD and IBS may share similar symptoms, but they are distinct conditions with different treatment requirements.

With IBD, the goal is to reduce inflammation that causes symptoms. IBS, on the other hand, may not be treatable with medications because there’s no identifiable bodily cause.

Symptoms for both conditions are manageable with treatment, so you can have a good quality life with either IBS or IBD.

A gastroenterologist can help determine your specific condition and offer the best treatment plan and resources to help you manage your symptoms.