Many people mix up the conditions that impact the gastrointestinal (GI) tract. IBS, Crohn’s disease, and ulcerative colitis all cause issues like frequent diarrhea, stomach pain, and blood in your stool.
How are IBS, Crohn’s, and ulcerative colitis different?
The short answer is Crohn’s disease and ulcerative colitis are both types of inflammatory bowel disease (IBD), which causes chronic inflammation of the intestines.
Irritable bowel syndrome (IBS), is a different noninflammatory condition that also affects the intestines (though some of the symptoms can overlap).
If your head’s spinning over gut disorders, don’t worry, we gotchu. Here’s the lowdown on Crohn’s and ulcerative colitis (the two major types of IBD), and (the less severe, but more common) IBS.
IBD is basically an umbrella term for certain conditions that involve chronic inflammation of the gastrointestinal tract. The two main types of IBD include ulcerative colitis and Crohn’s disease.
IBD conditions are life-long and currently have no cure. But don’t fret just yet — there are many ways to manage them.
What causes IBD? And who gets it?
No one knows exactly what causes IBD, but it seems to involve an irregular response by your body’s immune system.
According to the Centers for Disease Control and Prevention, about 1.3 percent of U.S. adults (3 million) had IBD in 2015. This was a pretty big jump from 1999, when 2 million Americans were afflicted.
You’re more likely to have IBD if you’re:
- over age 45
- white or Hispanic
- born in the U.S.
- live in a lower-income area
- live in the suburbs
Those with IBD are also more likely to have other chronic health conditions, including:
- cardiovascular disease (CVD)
- respiratory disease
- cancer
- arthritis
- kidney disease
- liver disease
IBD symptoms
Some common symptoms of IBD include:
IBD treatments
Though IBD isn’t curable, there are some things that can make it less of a headache — and gut ache. Some common treatments for IBD include:
- Medication. Your doc might prescribe amino salicylates, corticosteroids, immunomodulators, or “biologics” to help control symptoms.
- Vaccinations. Staying on top of vaccines may be especially important for those with IBD in order to limit the risk of infections. Vaccines like the Intranasal influenza vaccine, MMR, Varicella, and Zostavax are super vital.
- Surgery. In more severe cases, your doc may recommend surgery to remove damaged portions of intestinal tract.
IBS refers to a cluster of symptoms like stomach cramps and pain, bloating, constipation, and diarrhea that last for at least 3 months.
Unlike IBD, IBS is a syndrome, rather than a disease. It rarely requires hospitalization or surgery, and it also doesn’t increase your colon cancer risk.
Though IBS is def uncomfy, it doesn’t lead to serious disease or permanently damage the colon. Fortunately, most people can manage symptoms of IBS with diet changes, stress relief, and medication.
What causes IBS? And who gets it?
Someone you know fo sho has IBS, even if you don’t know it. That’s because IBS is among the most common disorders diagnosed by doctors. About 11 percent of the population worldwide and about 12 percent of people in the U.S. have it, though some estimates are as high as 20 percent.
The cause of IBS remains unknown, and there’s currently no known cure (boo, hiss).
Those more likely to get IBS may include:
- women
- those younger than 50
- those with a family member with IBS
- those with a history of childhood trauma
Those with IBS are also more likely to have other functional disorders including:
- fibromyalgia
- chronic fatigue syndrome
- chronic pelvic pain
- temporomandibular joint disorder (TMJ)
IBS symptoms
Common symptoms of IBS include:
- stomach cramps or pain
- frequent constipation
- frequent diarrhea
- feeling like you can’t “finish” a bowel movement
- alternating diarrhea and constipation
- stool mucus
- swollen or bloated stomach
- gas
- upper stomach discomfort
- nausea after eating
Women with IBS often report increased symptoms during their period.
IBS treatments
With no cure for IBS, there are still things that can help lessen discomfort and stress. Treatment recommended by a doctor may include:
- Dietary changes. Common lifestyle changes to ease IBS symptoms include nomming on more fiber-rich foods, drinking more water, and avoiding large meals. Foods including beans and legumes, dairy, caffeinated beverages, alcohol, wheat, processed foods, and fatty, fried foods may make IBS symptoms worse.
- Taking medication. Your doctor may recommend taking a fiber supplement, antidiarrheal meds, antispasmodic agents, antidepressants, or an IBS medication to manage symptoms.
- Counseling and stress relief. Cognitive behavioral therapy, psychotherapy, or hypnotherapy may help those with IBS control stress and manage symptoms.
The two distinct gastrointestinal disorders are easily confused, but they’re different conditions that have unique treatments.
At a glance, here’s how you can decipher between IBS and IBD.
| IBD | IBS |
| classified as a disease | classified as a syndrome (aka a cluster of symptoms) |
| can cause destructive inflammation, permanent intestinal harm, often requires surgery | doesn’t cause inflammation; rarely requires surgery or hospitalization |
| the disease can be seen with diagnostic imaging | during an exam, there’s no visible sign of abnormality |
| flares up during both low and high-stress situations | almost always flares up during stress |
| increased colon cancer risk | no increased colon cancer risk |
Crohn’s disease is a type of IBD that affects any part of the GI tract from the mouth to the colon. Most of the time, though, it can be found at the end of the small intestine (aka small bowel) and at the start of the colon (aka large bowel).
What causes Crohn’s disease? And who gets it?
Like all types of IBD, experts still don’t know what causes Crohn’s disease. It might be in response to an autoimmune reaction — where your immune system attacks healthy cells in your body — but doctors don’t know for sure.
According to the National Institute of Diabetes and Digestive and Kidney Diseases you may be more at risk based on:
- genetics
- smoking
- following a high fat diet
- regular use of anti-inflammatory drugs like ibuprofen or aspirin
- taking birth control pills
Crohn’s has become much more common around the globe in the last 50 years, with Northern Europe, the U.K., and North America reporting the highest cases. Calling all you millennials and Gen Xers: those aged 30 to 39 are most likely to have it.
Crohn’s disease symptoms
Crohn’s disease symptoms might include:
- abdominal pain
- frequent diarrhea
- occasional constipation
- fever
- blood in stool
- fatigue
- skin conditions
- joint pain
- malnutrition
- weight loss
Crohn’s disease treatments
Crohn’s disease is most often treated with the following:
- Medication. Your doctor may prescribe steroids, immune modifiers like azathioprine, amino salicylates, such as 5-ASA, and biologic therapy to treat Crohn’s. Antibiotics may also be prescribed in case abscesses from infections or fistulas develop.
- Surgery. In severe cases, some doctors might recommend surgery for Crohn’s disease, which might involve removal of a section of intestine. Sometimes, it can involve removing an entire organ like the colon. Surgery can’t cure Crohn’s, but it can make symptoms more manageable.
Since Crohn’s disease can increase the risk of colon cancer, those with this condition should also have regular colonoscopies.
Psst: Though the jury’s still out on this, some believe CBD can help ease IBD symptoms.
Unlike Crohn’s, ulcerative colitis is a chronic inflammatory disease exclusive to the colon. It causes small sores (aka ulcers) to form on the colon’s lining. Those ulcers create pus and mucus that can provoke tummy pain and the urge to frequently sprint to the nearest restroom.
What causes ulcerative colitis? And who gets it?
Docs still can’t pinpoint the precise cause of the disease, but it’s thought the following may contribute to ulcerative colitis:
- genetics
- an abnormal immune response
- the gut microbiome
- other environmental factors
Research also suggests that it could be the result of an interaction between infections in the colon and the bod’s immune response. Basically, experts think the inflammation response is prolonged in patients with ulcerative colitis, which is what causes all those achy, breaky ulcers.
Though anyone can get ulcerative colitis, most people are diagnosed in their mid-30s. These people are also more likely to get it:
- older men
- those with first-degree relatives with the disease
Ulcerative colitis symptoms
Common symptoms of ulcerative colitis include:
- diarrhea
- blood in stool
- mucus in stool
- abdominal pain
- frequent “gotta go” feeling
- fatigue
- appetite loss
- weight loss
- fever
- dehydration
- anemia
- joint pain or soreness
- irritated eyes
- skin rashes
Ulcerative colitis treatments
So far, there’s no one tried-and-true cure for ulcerative colitis. However, there are some treatments that can help you manage symptoms, including:
- Dietary changes. Certain foods can make symptoms worse. Some common trigger foods include dairy, caffeinated beverages, alcohol, juice, fried foods, spicy foods, red meat, and artificial colors, flavors and sweeteners. Your doc may also recommend a modified ulcerative colitis diet to combat symptoms.
- Medication. Medication like amino salicylates, corticosteroids, immunomodulators, and biologics might be prescribed to stop or ease symptoms. A doctor might also prescribe pain relievers like acetaminophen, antibiotics, antidiarrheal medication, or medication that minimizes colon spasms.
- Surgery. Severe symptoms that can’t be controlled by medicine may require surgical intervention. The surgery involves removing the colon and some or all of the rectum and anus.
Like with Crohn’s, some also cite ulcerative colitis relief with help from a little CBD. Probiotics may also help maintain a healthier gut microbiome.
If you think you have UC, seek support ASAP. Left untreated, UC can lead to serious conditions including:
- holes in the colon
- colon cancer
- liver disease
- osteoporosis
- anemia
Ulcerative colitis and Crohn’s are the two types of IBD, which means they both cause GI tract inflammation. However, they manifest pretty differently. Here’s what to know:
| Ulcerative colitis | Crohn’s disease |
| only occurs in the colon and the rectum | affects any part of the GI tract (from the mouth to anus), most often affects small intestine |
| damaged areas are continuous (not patchy) spread from the rectum into the colon | damaged areas are patchy and next to healthy tissue |
| inflammation only exists in the colon’s innermost lining | inflammation may spread through multiple GI tract walls |
According to a 2014 review, Crohn’s tends to be a lot more severe than ulcerative colitis, but it’s also much less common.
Living with stomach and digestive issues is uncomfy at best and debilitating at worst. If you’re having gastrointestinal probs but aren’t sure whether IBS or some form of IBD (Crohn’s disease or ulcerative colitis) is to blame, visiting the doc can help.
Your doctor will likely refer you to a gastroenterologist, where you might undergo a test like a colonoscopy, CT scan, or pelvic exam. Once you receive your diagnosis, your doc will recommend treatment, possibly in the form of lifestyle changes, medication, therapy, stress management, or surgery.
While there’s currently no cure for IBS or IBD, there are certainly steps you can take to live more comfortably.
Keep in mind that since untreated IBD can lead to colon cancer or other diseases, seeking treatment ASAP is key.