IBD vs IBS | Inflammatory Bowel Disease vs Irritable Bowel Syndrome
The two terms, IBD and IBS that will be discussed in this section are somewhat similar in name sake, and thus, confused on most of the occasions due to that, also with the not so clear cut origins and treatment strategies used to manage these. Both are conditions that cause much inconvenience, and one can lead to life threatening complications and may require surgical treatment. Both carry much psychological affects, and need to be managed in the proper context to reduce non compliance and associated unnecessary complications. IBD, or inflammatory bowel disease, and IBS, irritable bowel syndrome, are both diseases affecting the gastro intestinal tract. They can be compared in the aetiology, pathophysiology, symptoms, complications, management and follow up. Though both these have vast depths for discussion, the basic principles will be discussed here.
IBD (Inflammatory Bowel Disease)
IBD is an autoimmune disease admixed with the excessive cytokine activity, with two major sub diagnoses, that is ulcerative colitis and Crohn’s disease. It affects the colon alone in all parts of the gastro intestinal tract. These two types differ in the depth of mucosal affliction, and the pattern of distribution on the mucosa itself, from continuous to skipped areas with cobblestone appearance. They present with abdominal pain, vomiting, diarrrhoea, rectal bleeding, severe cramps, weight loss, and extra intestinal manifestations like arthritis, pyoderma gangrenosum, uveitis, sclerosing cholangitis etc. They are associated with risks of nutritional deficiency and risk at malignancy. Management is done through steroids to manage flare ups, and immune suppression for maintenance, and surgery if required to resect a section of afflicted bowel. This condition carries a poor quality in life due to its flare-ups, need for regular medications, and the possibility of severe complications.
IBS (Irritable Bowel Syndrome)
IBS, a diagnosis of exclusion, is usually associated after an infection, following a stressful life event without any other major medical indicators. There are multitudes of risk factors, but without any specific causative mechanism. Most suspect a psychogenic origin, which is supplemented by the neurogenic sensitivity to stretching in the intestines. The symptoms of this condition may range from mild to severe, and are usually a spectrum of constipation, diarrhea, abdominal cramps, excessive urge to defeacate, etc. These are usually more common following a meal, and will have peaks and troughs, and reduced following a bowel movement. This is not usually related with any complications, and the management is based on prevention of aggravation of bowel movement, and managing the symptoms of bowel motility and managing abdominal pain.
What is the difference between IBD and IBS?
Both IBD and IBS present with changes in the bowel motility and loss of appetite. It requires specific investigations to exclude sinister pathologies. Both would complain of diarrhea, distension, abdominal pain and mucus. The symptoms are worsened in menses, and associated with fibromyalgia, anxiety and depression. IBD is an autoimmune condition, whereas IBS is aetiology; still shrouded in mystery, and thought to be combined neuromuscular and psychogenic debilities. There are no visible pathologies in IBS, whereas IBD create a great many pathological changes in the gut lumen. IBS has alternating diarrhea and constipation, whereas IBD doesn’t. IBD present with rectal bleeds, fistula, strictures, etc. IBS doesn’t have extra intestinal manifestations, but IBD does. IBD is complicated with liver disease, osteoporosis and colonic cancer.
Both these conditions with altered bowel habit cause great strife, and IBD alone can complicate to life threatening events unless properly managed. IBS, alone cause nothing greater than a nuisance, but in the long run can cause psychological and nutritional problems.