IBS (Irritable Bowel Syndrome) and IBD (Inflammatory Bowel Disease) are two gut related conditions that affect millions of people in the UK – indeed around 10-20% of the UK are thought to have IBS and a further 1 in 123 people are estimated to have IBD.
Symptoms of the two conditions can be similar, but the conditions and treatments are very different, which is why an accurate diagnosis is so important. In this article, we will look at the symptoms and treatment options of each.
IBS – Irritable Bowel Syndrome
Common Symptoms :
- Abdominal pain
- Bloating
- Diarrhoea / constipation / combined
- Excess gas
- Mucus in stool
Irritable Bowel Syndrome is a ‘functional gastrointestinal disorder’ which means that whilst IBS can result in painful symptoms, which can significantly impact someone’s quality of life, there is no visible structural damage to the gut. People with IBS report that symptoms can worsen during times of stress, after eating certain foods and with hormonal changes, making them unpredictable to live with and manage.
What Causes IBS?
We don’t quite know what causes IBS, but increased gut sensitivity, abnormal muscle contractions and bacteria imbalances are all thought to be contribute. Research points to symptoms being aggravated or triggered by stress, infections, and certain foods such as fatty foods, caffeine and artificial sweeteners.
Diagnosing IBS
There is no definitive test, such as a blood test, for IBS. Instead a diagnosis of IBS is made by looking at the pattern of symptoms and excluding other conditions, such as IBD. It is extremely helpful to keep a detailed record of symptoms (bowel habits, form and appearance and pain patterns) along with possible triggers (foods, stress, times of eating) for a week or two and share this with your gastroenterologist at your appointment.
To rule out certain conditions, you may be advised to have:
- Blood tests: to check for anaemia, inflammation, or coeliac disease.
- Stool tests: to exclude infection, inflammation or blood.
- colonoscopy or imaging: Occasionally, a colonoscopy or imaging will be suggested if the pattern of symptoms or stool tests suggest this may be helpful.
Treating IBS
Treating IBS isn’t just about finding a medication routine. Lifestyle changes, such as exercise, reducing stress and dietary changes (including eating fermented foods that have naturally occurring probiotics) have all been shown to make a difference.
There are some medications that can ease the pain and discomfort associated with IBS, depending on the symptoms. These include:
Antispasmodics
- Loperamide: to slow bowel movements
- Laxatives: to ease constipation
- Low dose of antidepressant: can improve brain-gut communication
- Medications if bile acid issues are present
IBD – Inflammatory Bowel Disease
Common Symptoms:
- Abdominal pain
- Changes in bowel habits
- Persistent diarrhoea
- Blood / mucus in stools
- Fatigue
- Weight loss
Inflammatory Bowel Disease is a term used to describe chronic inflammatory conditions that affect the digestive tract. Patients with IBD experience structural damage to their gut wall and ulceration – which is why early and accurate diagnosis is key to ensuring long term damage is minimised.
There are two main types of IBD, Crohns disease and Ulcerative colitis. A third less common form is microscopic colitis resulting in microscopic inflammation of the large bowl resulting in symptoms of profuse watery diarrhoea.
Crohn’s Disease
Affecting any part of the digestive tract, Crohn’s results from inflammation of the digestive tract. Symptoms include all those above, plus sometimes mouth ulcers and perianal disease (fissures and abscesses).
Ulcerative Colitis
Affecting the large intestine and rectum, ulcerative colitis involves a continuous inflammation of the lining of the bowel wall, which results in bloody diarrhoea, an urgency to pass stool, pain and tiredness.
What Causes IBD?
There is no one direct cause of inflammatory bowel disease, instead it is thought to be an interplay between several factors, including:
Genetics: IBD often runs in families.
Immune System Issues: In IBD, the body’s immune system is inappropriately activated resulting in inflammation to the bowel.
Environmental Aspects: Smoking, diet, antibiotic use, infection and geographic upbringing have all been implicated as possible factors in the development of IBD.
Gut microbiome imbalances: This is thought to play a key role in IBD development.
Diagnosing IBD
Again, there is no one simple test for IBD, rather a combination of physical examinations, medical history taking and laboratory tests. These are essential to rule out other conditions that share similar symptoms.
You will likely have blood and stool tests (to test for certain markers found with IBD), and may be advised to have an endoscopy or colonoscopy to allow direct visualisation of any inflammation or damage to the digestive tract. An MRI or CT scan by also be recommended.
Treating IBD
Several medications are available to treat IBD, reduce inflammation and manage flares. These require careful monitoring. Lifestyle changes will also be recommended, including dietary changes, supplements if gut absorption is impaired and smoking cessation. In some cases, surgery maybe needed if medications fail or there are complications. For some, removing part of the bowel can be curative.
Conclusion
Although IBS and IBD share some similar symptoms, they are very different conditions that require different approaches to diagnosis and treatment. IBS is a functional disorder that can cause significant discomfort but does not damage the digestive tract, while IBD involves chronic inflammation that can lead to structural changes in the gut and requires ongoing medical management.
Because of these differences, it is essential not to ignore persistent digestive symptoms or assume they are “just IBS.” Seeking medical advice, keeping track of symptoms, and undergoing appropriate tests can help ensure the correct diagnosis is made. With the right support — whether that involves medication, dietary adjustments, stress management, or specialist care — many people are able to manage their symptoms effectively and maintain a good quality of life.
If you are experiencing ongoing gut symptoms such as persistent pain, changes in bowel habits, unexplained weight loss, or blood in your stool, it is important to speak to a healthcare professional. Early assessment and the right treatment plan can make a significant difference to both symptom control and long-term digestive health.
Dr Suranga Dharmasiri, Consultant Gastroenterologist at Haven Medical and one of the UK’s leading experts in inflammatory bowel disease, treats hundreds of patients with these conditions every year. Appointments with Dr Dharmasiri are available by calling 01202 110303.
