IBD vs IBS – let’s talk it out

It’s a serious misconception out there among some people that the similarity in acronyms and the word ‘bowel’ across both must mean that IBD and IBS are fairly similar.

It drives me crazy.

Irritable bowel syndrome can be an unpleasant thing to experience for some people. I’d wager in some cases it can even be quite nasty. But when people flippantly refer to IBD as ‘irritable bowel disease’, rather than ‘inflammatory bowel disease’, it does nobody any favours. It furthers the notion that somehow IBS is comparable to Crohn’s and ulcerative colitis. That if people with IBD could just manage their stress and eat some more fibre, all of their problems would go away. I can’t tell you how many times people have asked me if I’ve tried adapting my diet. If I’ve tried cutting out gluten.

My internal monologue at these moments tends to run along the lines of ‘I’ve just told you I’m having surgery to remove part of my intestines, don’t you think I’d have maybe given diet a shot before getting to this point?’ Externally, of course, I tend to smile tightly and nod.

Yes. I’ve bloody tried cutting out gluten.

Let’s clear it up. Once and for all. IBS is irritable bowel syndrome. According to some figures, it affects 10-20% of all adults. By contrast, IBD, or inflammatory bowel disease (including both Crohn’s and UC) affects only 0.001- 0.003% of the adult population. But it’s not just about being some kind of exclusive club that talks way more about bathroom habits than the average medical gathering. Inflammatory is the key word. People with IBS don’t have inflammation of the intestines (or any other part of the GI tract, for that matter). They may have some abdominal pain, some bathroom related inconvenience, but they don’t have structural changes in the layers of their intestinal wall. They don’t bleed, seep or otherwise ooze. They don’t run the risk of absesses or fistulae forming between bowel and skin – or bowel and other non-digestive organs.

Again with the according to some figures, 70% of IBS patients either don’t need to or choose not to seek healthcare. Virtually all people with IBD will have ongoing healthcare provider contact, given that virtually all people with IBD need some serious meds at some point in their journey, if not constantly. IBS doesn’t need surgery; IBD often will – you’ve heard enough about my ostomy by now, and it sure didn’t just appear one day. Surgery and symptoms them selves can have significant enough complications that it’s not unheard of for IBD patients to die of related causes. Not common, but it is a risk. IBS – not so much.

We IBDers also run the risk of symptoms beyond the gut. Lucky us, eh? Complications can arise in the skin, joints, even the eyes. IBD is autoimmune, and therefore can have some similarities in symptoms with the likes of rheumatoid arthritis. We even share some of our more serious meds with them. When you’re 23 and your knee is playing up, that’s a bit of a health-related wake-up call. We also can run fevers and become severely anaemic and/or malnourished. Not to mention, all of the mentioned symptoms are just the disease-related ones – not even the extra fun that can be in store for those of us on certain medications.

Don’t get me wrong. I know some people who have some thoroughly unpleasant cases of IBS to deal with. It sucks. I wouldn’t wish ill digestive health on anyone. But to equate the two is to be at best uninformed or at worst, downright inconsiderate. It’s like equating a sprained ankle with a compound fracture. One, you can walk off. The other requires a hell of a lot more attention. Unlike an ankle injury of that nature, though, both IBS and IBD are chronic, and that sucks. I’m happy to share in the pain of IBS sufferers – but if they start to try to tell me they know how I feel, that’s where the civility will end.

So if you’re reading this and knew the basics already, arm yourself with the details for your next encounter. If you’ve just been enlightened, educate others if the topic should ever arise. If you have IBS, know that we know it’s horrible to have a busted gut. But know too that you are damn lucky to have an inflammation-free GI tract, for so many reasons.

(figures primarily from badgut.org, the Canadian Society for Intestinal Research. It was the first website that had decent details on it, but other websites like CCFA etc have similar information)

One thought on “IBD vs IBS – let’s talk it out

  1. Yes I feel your pain! I find it extremely irritating when people try and tell me about “diets” for my Crohn’s Disease when they themselves do not have IBD.
    Very good information here, great job 🙂

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