IBS vs Crohn's
If you have both Crohn’s and irritable bowel syndrome (IBS), you might find it hard to figure which condition is causing your symptoms. Understanding the similarities and differences can help you to figure out how to better manage and treat symptoms.
What is Crohn’s Disease?
Crohn’s disease is a harsh and debilitating chronic inflammatory bowel disease that causes inflammation, ulcers, and digestive tract bleeding. There are at least 780,000 Americans in the United States with Crohn’s according to the Crohn’s & Colitis Foundation of America (CCFA).
There is no known cause for Crohn’s but it appears to run in families. Some research, including one study from the California Institute of Technology, indicates that Crohn’s is linked to an overactive response to intestinal bacteria, which may eventually lead to damage of the intestines.
Symptoms of Crohn’s Disease include:
- Abnormal pain and cramping
- Rectal bleeding and anemia
- Weight loss and appetite reduction
- Fevers
- Fatigue and low energy
Treatments include diet changes and biologic treatments. Surgery is also an option for treating Crohn’s disease.
What is IBS?
IBS is a condition that produces symptoms similar to Crohn’s, but they are not the same condition.
According to the International Foundation for Functional Gastrointestinal Disorders (IFFGD), IBS affects between 25 to 45 million Americans. It affects mostly women, but it can affect people of all ages, including children.
Researchers are uncertain what causes IBS but environmental factors (i.e. food, genetics, gastrointestinal infects), gut physiology (i.e. abnormal gut response), and psychological factors (i.e. stress, anxiety) might be to blame according to one report published in The American Journal of Medicine.
Symptoms of IBS include:
- Abdominal fullness, gas, bloating, and pain
- Diarrhea
- Constipation
A diagnosis of IBS is generally made based on symptoms.
You can control symptoms by managing your diet, lifestyle, or stress. Other treatment options include over-the-counter (OTC) medication and therapy.
Crohn’s, IBS Or Both?
It is not always easy to tell the difference when it comes to symptoms of Crohn’s and IBS. This is not just a problem for patients – doctors can also struggle to distinguish between the two, resulting in misdiagnosis or incorrect treatments.
IBS vs Crohn's: Symptoms
IBS causes symptoms of abdominal pain and bloating, constipation, or diarrhea which lead to frequent trips to the bathroom. While it shares some symptoms with Crohn’s, the symptoms of Crohn’s are much more extreme.
Crohn’s disease causes inflammation in the digestive track, leading to severe abdominal pain, fever, blood in stools, and weight loss. Moreover, Crohn’s disease blood work shows markers of inflammation, endoscopies and imaging generally show digestive tract abnormalities and damage, and biopsies indicate tissue abnormalities.
Crohn’s is often considered an autoimmune disease because it is known for causing non-bowel symptoms, including joint pain and skin reactions related to inflammation.
Diagnosis
In reaching a diagnosis, your doctor will want to know about your symptoms, overall health, and lifestyle. He or she will run blood tests and order imaging to see what is happening with your bowel.
If you have IBS, your tests will come normal because IBS is not a disease; it is actually a cluster of a symptoms. Further, your gut will look normal on imaging and show no signs of infection.
By contrast, your blood work for Crohn’s will show inflammation. Imaging may also indicate inflammation, as well as ulcers.
Treatment Differs for IBS vs Crohn's
Your treatment for Crohn’s disease depends on the severity of symptoms. Medication is the most common method for treating Crohn’s.
The five categories of Crohn’s medications are:
- Corticosteroids
- Aminosalicylates
- Antibiotics
- Immune modifiers
- Biologic therapy
Your doctor may prescribe a corticosteroid, called prednisone, to reduce inflammation, but prednisone is only prescribed in small doses and for a short time.
Aminosalicylates are usually a first option for treating ongoing inflammation in Crohn’s patients.
If your doctor prescribes an antibiotic, chances are it is for treating a bacterial infection or bacteria overgrowth in your small intestine.
When aminosalicylates don’t help, immune modifiers are a next step. They work by stopping your immune system from causing inflammation.
When corticosteroids, aminosalicylates, antibiotics, and immune modifiers aren’t helping, biological drugs may. These drugs attach themselves to inflammation promoting proteins in order to halt their ability to cause inflammation.
Sometimes, Crohn’s may require surgery, for example, to repair intestinal blockages. Surgery is not a cure, but at least 70 percent of people with Crohn’s will require surgery at some point according to CCFA.
While Crohn’s treatment is aimed at treating and stopping inflammation, IBS treatment is aimed at managing symptoms.
Over-the-counter medications may help treat some of the symptoms of IBS, including diarrhea and constipation. Diet also plays a role in treating and managing IBS flares.
The American College of Gastroenterology recommends limiting gas-producing foods (beans, onions, cabbage, etc.), drinking plenty of water, minimizing sugar intake, eating slower, and avoiding overeating, carbonated drinks, and some dairy products.
You should also add soluble fibers (i.e. psyllium) to relieve your symptoms. Probiotics (i.e. yogurt) may also help relieve bloating and gas.
There isn’t a specific or recommended diet for Crohn’s disease, but eating healthy can help your immune system to better function. You should avoid foods that trigger your symptoms.
It is also important to quit smoking with either condition, as smoking can make symptoms worse.
And since both of these conditions are further exacerbated by stress, stress reduction techniques help. Mediation, regular exercise, yoga, and talk therapy can help you to relax and keep your symptoms at bay.
Outlook
IBS and Crohn’s may share similar symptoms, but they are two very different conditions. There is no cure for either condition, but most people can live normal lives with one or both.
It is possible to manage each condition with treatment and lifestyle changes to minimize symptoms, damage, and complications.