Understanding the Difference Between IBD and IBS

June 17, 2015 Uma Pisharody, MD, FAAP

IBD (Inflammatory Bowel Disease) and IBS (Irritable Bowel Syndrome) are two completely different conditions that share very similar acronyms.   Often I find people confused about them, even presuming they may have one, when in fact, they actually have the other.  To clarify the vast differences between the two conditions, and why the distinction is important, here’s what I consider key facts about IBD and IBS:

IBD (Inflammatory Bowel Disease):  A group of diseases, including Crohn’s disease and ulcerative colitis, caused by a disordered immune response resulting in inflammation in the gastrointestinal (GI) tract.  These diseases must be treated aggressively (with powerful medications and/or diet, both usually used lifelong), without which, the disease will often progress, potentially even causing life-threatening complications.

 IBS (Irritable Bowel Syndrome):  This is a “disorder” of the GI tract, not a disease.  With IBS, there are symptoms like abdominal pain, constipation, and diarrhea, but these symptoms are not due to any internal disease or inflammation within the bowel.  IBS does not lead to harmful complications, even if left untreated.         

A disease
Not a disease, but a "disorder"
Caused by internal inflammation
No inflammation present
Must be treated aggressively or will lead to serious complications Won’t cause serious harm if choose not to treat
Can lead to cancer Does not carry a risk of cancer
Risk of needing surgery No risk of needing surgery

Why this matters to me:  When I meet children who come to see me for "tummy troubles," I always want to know if there are any GI diseases that run in the family. Both IBD and IBS can be inherited, so knowing whether close relatives have these conditions is important.  Having afirst-degree family member with IBD is actually one of the biggest risk factors for developing this disease (especially in childhood). Since the symptoms of IBS and IBD can be similar, knowing the family history can change the way I choose to test or treat my patients.

If you have questions about whether your child’s symptoms could be from IBD or IBS, the pediatric gastroenterology team at Swedish Pediatrics is here to help. 


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