Digestive Health Inflammatory Bowel Disease The Differences Between IBD and IBS IBD and IBS Have Similar Symptoms—How Can We Tell Them Apart? Print By Amber J. Tresca | Medically reviewed by a board-certified physician Updated May 31, 2018 Unintended weight loss is part of ulcerative colitis and Crohn's disease, but not irritable bowel syndrome. Ian Hooton More in Inflammatory Bowel Disease Diagnosis Living With Support & Coping Crohn's Disease Ulcerative Colitis Related Conditions Surgery Nutrition Treatment View All Two disorders that are frequently confused, although they are completely different conditions, are irritable bowel syndrome (IBS) and inflammatory bowel disease (which includes both Crohn's disease and ulcerative colitis, collectively known as IBD). Although IBS and IBD sound similar because of their acronyms, and might cause similar symptoms, they are totally distinct conditions with very different disease courses. In addition, they are treated quite differently and the medications used for one are not going to be helpful for the other. IBS is a functional disorder: even though the symptoms are real and can be severe, there are no abnormalities found in the large intestine during testing, such as an endoscopy, and no evidence of disease is found during the examination of a biopsy of intestinal tissue. IBD, however, is a disease which causes obvious abnormalities that are seen during testing. When IBD goes untreated it can lead to serious complications that can occur both inside and outside of the digestive system, while IBS is not associated with these issues. In addition, complications from IBD can be severe enough to be life-threatening, while this is not true for IBS. In view of all these factors, the differences between IBD and IBS are actually quite significant, although it might not seem that way on the surface because they both routinely cause diarrhea and pain. Many people commonly confuse the two conditions or even use incorrect terms like "irritated bowel disease" or "inflammatory bowel disease," both of which are not correct terms and are not conditions that exist. IBS and Ulcerative Colitis Are Different IBS is often confused with ulcerative colitis or colitis, but they are not the same condition. Both conditions affect the large intestine and may cause diarrhea, but that is as far as the similarities go. IBS is a syndrome, it is not a disease. Ulcerative colitis is associated with a risk of colon cancer, and having IBS does not increase the risk of colon cancer. IBS does not cause intestinal bleeding and ulcerative colitis does. "Colitis" is a rather broad term that refers to any general inflammation in the colon and it could be caused by several different conditions, including bacterial infections or IBD. Colitis is a sign of ulcerative colitis or of Crohn's disease—it is not a part of IBS. 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, can also be dangerous. Treatments for IBD often involve drugs, such as immunosuppressives, biologics, and steroids. IBS is often treated with diet and lifestyle changes, but when drugs are needed, antispasmodics or antidepressants are sometimes used. Endoscopic Differences Endoscopy refers to the tests that are done to look inside the intestines or other body structures. In some cases, people who are suspected of having IBS may have a colonoscopy or other tests to rule out other potential conditions. When a physician looks inside the colon of a person with IBS, there will be no evidence of disease found. This is because IBS is a functional disorder, not an organic disease, and it does not cause changes in the intestinal wall. Crohn's disease and ulcerative colitis can cause extensive damage to the intestinal walls. When looking inside the colon of a person with Crohn's disease in the large intestine, a physician may see ulcers (or holes), inflammation, and parts may look like cobblestone. Biopsies (pieces of tissue taken from the body and sent for evaluation under a microscope) will show even more changes. The colon of a person with ulcerative colitis will also show inflammation and ulcers, and a biopsy will show changes in the cells. The table below is by no means a complete or hard-and-fast list of signs and symptoms but does give a general idea of the basic distinguishing factors between IBS and IBD. Differences Between IBD and IBS Intestinal Symptoms IBS Crohn'sDisease UlcerativeColitis 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'sDisease UlcerativeColitis 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'sDisease UlcerativeColitis 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 X Was this page helpful? Thanks for your feedback! We're providing tips on how to take better care of your gut. Email Address Sign Up There was an error. Please try again. Thank you, , for signing up. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Crohn's and Colitis Foundation of America. "What is Ulcerative Colitis?" CCFA.org. Apr 2017. Crohn's and Colitis Foundation of America. "What is Crohn’s Disease?" CCFA.org. Apr 2017. Sachar DB, Walfish AE. "Crohn's Disease (Regional Enteritis; Granulomatous Ileitis or Ileocolitis)." The Merck Manual Dec 2012. Sachar DB, Walfish AE. "Ulcerative Colitis." The Merck Manual Dec 2012. Torpy JM. "Irritable Bowel Syndrome." JAMA 22 Feb 2006;295. doi:10.1001/jama.295.8.960 Continue Reading Article Why Psoriasis and IBD May Occur Together Article If You Don't Have IBS, What Else Could Cause Your Symptoms? Article The Link Between IBD and Depression Article Differences Between Ulcerative Colitis and Crohn's Disease Article An Overview of Inflammatory Bowel Disease (IBD) Article The Differences Between an Ileostomy and a J-Pouch Article Crohn's Colitis and Inflammation in the Colon Article How Do I Know if I Have Crohn's Disease? Article IBD Can Bring Serious Problems to Your Teeth and Gums Article What Are Pseudopolyps? Article IBD Can Be Associated With Liver Disease Article What Is Endoscopic Remission in IBD? Article Why One Study On Fungus Is Not the Answer to IBD Article What You Need to Know About Indeterminate Colitis Article How Having IBD Impacts a Woman's Ability to Get Pregnant Article Can You Prevent IBD Through Breastfeeding?