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The Differences Between IBD and IBS

IBD And IBS Have Similar Symptoms -- How Can We Tell Them Apart?

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Updated June 17, 2014

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Unintended weight loss is part of ulcerative colitis and Crohn's disease, but not irritable bowel syndrome (IBS).

Image © IAN HOOTON

Many intestinal disorders have similar symptoms, which can make diagnosis difficult. Irritable bowel syndrome (IBS) and inflammatory bowel disease (which includes both Crohn's disease and ulcerative colitis, collectively known as IBD) in particular have several symptoms in common. The differences between IBD and IBS are actually significant, although it might not seem that way on the surface.

IBS and Ulcerative Colitis Are Different

IBS is often confused with ulcerative colitis or colitis, but they are not the same condition. IBS is a syndrome, not a disease, it does not lead to colon cancer, and it does not cause bleeding. Ulcerative colitis, however, is a disease, can put patients at risk for colon cancer, and bleeding is a common symptom.

Differences in Treatments for IBD and IBS

Therapy and medications for IBS vary hugely from those for IBD. An incorrect diagnosis and treatment plan can not only be ineffective but in some cases also be dangerous.

The tables below are by no means a complete or hard and fast list of signs and symptoms, but do give a general idea of the basic distinguishing factors between IBS and IBD.

Differences Between IBD and IBS

Intestinal Symptoms IBS    Crohn's
Disease   
Ulcerative
Colitis   
Alternating diarrhea/constipation      X    
Abdominal pain   X   X   X
Bloating/Distension   X   X   X
Mucus   X   X   X
Persistent diarrhea   X   X   X
Loss of Appetite     X   X
Rectal bleeding     X   X
Fistulas     X  
Strictures     X  
       
Extra Intestinal Symptoms IBS    Crohn's
Disease
Ulcerative
Colitis
Worsening of symptoms during menses      X   X   X
Anemia     X   X
Delayed growth and sexual maturation in children        X   X
Eye irritations     X   X
Fever     X   X
Skin irritations     X   X
Weight loss     X  X
       
Related Conditions IBS Crohn's
Disease
Ulcerative
Colitis
Urinary Conditions   X   X   X
Fibromyalgia   X   X   X
Anxiety   X   X   X
Depression   X   X   X
Arthritis     X   X
Liver Complications     X   X
Osteoporosis     X   X
Colon Cancer       X

Sources:

Crohn's and Colitis Foundation of America. "What is Ulcerative Colitis?" CCFA.org 2012. 27 Aug 2012.

Crohn's and Colitis Foundation of America. "What is Crohn’s Disease?" CCFA.org 2012. 27 Aug 2012.

Sachar DB, Walfish AE. "Crohn's Disease (Regional Enteritis; Granulomatous Ileitis or Ileocolitis)." The Merck Manual January 2007. 2 Jun 2009.

Sachar DB and Walfish AE. "Ulcerative Colitis." The Merck Manual January 2007. 2 Jun 2009.

Torpy JM. "Irritable Bowel Syndrome." JAMA 22 Feb 2006;295. 2 Jun 2009.

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