Is it IBD or IBS? Here is a primer on the differences between these two conditions. If you suspect you have one of them, ask your doctor for specific diagnostic tests such as colonoscopy, endoscopy, and imaging techniques such as CT, ultrasound and MRI. Routine blood and stool tests should be conducted to rule out other possible conditions.
Inflammatory bowel disease (IBD)
‘ Ulcerative Colitis
This affects only the colon (large intestine), producing painful ulcers and inflammation in the colon’s lining, which can lead to permanent damage.
Symptoms include cramping, bloating, diarrhea, bleeding, constipation and fatigue. (While the symptoms of colitis and Crohn’s disease are very similar, colitis is more commonly associated with bloody diarrhea, pain and urgency.)
‘ Crohn’s disease
Crohn’s can strike anywhere in the digestive system, including the esophagus, causing debilitating ulcers and inflammation, which can lead to fistulas or perforations requiring surgical repair.
Symptoms include cramping, bloating, diarrhea, constipation, bleeding and fatigue.
Treatment options for IBD fall into two categories: those for controlling inflammation in the gut and those for managing symptoms. Biologics are one type of drug available to combat inflammation. These are administered intramuscularly and are designed to engage the immune system in a different way than other meds. They are used to relieve the painful symptoms of IBD. Jim Rama, a Vancouver pharmacist, says these drugs are ‘life-changing’ compared to the oral medications, but they are costly to produce: Patients pay approximately $1,500 per dose, and the drug has to be administered once or twice a month. Check with your provincial medical plan; some cover biologics if you provide a letter from your doctor and/or satisfy certain criteria.
Consult with your doctor about supplements, as some medications affect the absorption of certain minerals and vitamins.
Irritable bowel syndrome (IBS)
Sometimes called ‘spastic colon,’ IBS is a functional disorder of the colon that does not involve inflammation. IBS results in chronic painful spasms in the colon that produce cramping, bloating, diarrhea and constipation’symptoms similar to IBD. Pain can move from one location to another, and can occur either occasionally or frequently. Fatty foods, milk products, chocolate, alcohol, and caffeinated and carbonated drinks can trigger symptoms. Eating small meals throughout the day may reduce symptoms.
IBS is the most common disorder in Canadians who consult a specialist for gastrointestinal symptoms; it affects up to 20 percent of the population (and significantly more women than men). It can begin as early as childhood, and can disappear and reappear throughout an individual’s lifetime. Stress can exacerbate symptoms. There is no evidence that IBS leads to IBD.
IBS medications target bowel spasms, diarrhea, constipation, pain, anxiety and depression. Flare-ups can be reduced by monitoring your diet, exercising regularly and practising stress relief through yoga, meditation or mindfulness.