You’ll need to work with your doctor to find the best combination of medicine, diet, counseling, and support to keep flare-ups down and quality of life way up.
Though their initials are close, their symptoms may initially seem similar, and they’re both chronic conditions, IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease) are distinctly different and separate ailments.
IBS is a common disorder of the intestinal tract that is thought to affect as many as one in five adult Americans, more often women than men. About half the people with IBS begin to experience symptoms in their youth, before the age of 35. Irritable bowel syndrome is characterized by its signs and symptoms, not by anatomical, physical or chemical problems. That’s why it’s called a syndrome rather than a disease. IBS doesn’t lead to more serious diseases, such as cancer, Crohn’s disease or ulcerative colitis, and it doesn’t permanently harm the intestines.
What it does do is cause a great deal of discomfort and distress. Unfortunately, according to the National Institutes of Health, up to 70 percent of people suffering from IBS are not receiving medical care for their symptoms. Though no cure yet exists for IBS, there are many options available to treat the symptoms, including new drugs and refined behavioral and dietary approaches.
Everyone experiences occasional stomach upsets and disruptions in their normal bowel movements. But everyone doesn’t experience these episodes frequently or intensely. The American College of Gastroenterology recommends this quick self-test: Do you have recurrent abdominal pain or discomfort? Do you often feel bloated? Are you frequently constipated? Do you have frequent diarrhea? If you answered yes to one or all of these symptoms, you may have IBS, a real and treatable medical condition, and seeing your doctor can put you on the path to relief.
Investigating your IBS
There is no specific test for IBS, but diagnostic tests may be performed— including stool sample testing, blood tests, and x rays—to rule out other problems. Typically, a doctor will perform a sigmoidoscopy or colonoscopy, which allows examination inside the colon.
If your test results are negative, the doctor may diagnose IBS based on your symptoms, including how often you’ve had abdominal pain or discomfort during the past year, when the pain starts and stops in relation to bowel function, and how your bowel frequency and stool consistency have changed. One marker of IBS is having abdominal pain or discomfort for at least 12 weeks (not necessarily consecutive) out of the previous 12 months.
The specific cause for IBS isn’t known, but researchers theorize that people with the condition have a colon, or large intestine, that is particularly sensitive and reactive to certain foods and stress. That may be why, for many people, a controlled diet reduces IBS symptoms.
Figuring out the right symptom-reducing diet for an individual often starts with keeping a journal that notes which foods seem to cause a flare-up or worsening of distress. Common culprits include gas-producing foods, the sugar substitute sorbitol, caffeine, alcohol, and large meals in general. Your doctor will help you devise a personalized plan that includes the right amount of fiber, fat, and carbohydrates to keep your symptoms controlled and your nutrition healthy.
Medications play an important role in symptom relief. Medications affect people differently, and no one drug or combination of drugs has beenshown to work for everyone with IBS. Options include fiber supplements or laxatives to deal with constipation and medicines to decrease diarrhea. Antispasmodic drugs can be effective in controlling colon muscle spasms and reducing abdominal pain. Newer medications have been successful in treating both IBS with constipation and IBS with diarrhea, but because of their side effects are not good choices for every patient.
IBD: Crohn’s disease and ulcerative colitis Inflammatory bowel disease (IBD) is the general name for diseases that cause inflammation in the small intestine and colon. IBD is both more rare than IBS (an estimated 1.4 million Americans suffer from it) and more serious. Though it’s wise to seek doctor’s help for irritable bowel syndrome, it is imperative to have a gastroenterologist’s care for inflammatory bowel disease. Unlike IBS, which does not lead to other diseases, IBD frequently results in complications and increases the risk of colon cancer.
There are two main types of IBD: Crohn’s disease and ulcerative colitis.
It affects men and women equally and seems to run in families, with about 20 percent of people with Crohn’s or ulcerative colitis having a blood relative with some form of IBD. It’s most often diagnosed in young people under the age of 30.
Crohn’s disease is a chronic disorder that causes inflammation of the digestive tract. It can affect any area of the digestive tract, from the mouth to the anus, but is most commonly present in the lower part of the small intestine, called the ileum. The most common symptoms of Crohn’s disease are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, arthritis, skin problems, and fever may also occur. Bleeding may be serious and persistent, leading to anemia. The range and severity of symptoms varies.
Ulcerative colitis causes inflammation and sores, called ulcers, in the lining of the rectum and colon. The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhea. Patients may also experience fatigue, weight loss, loss of appetite and other symptoms. About half of the people with ulcerative colitis have mild symptoms. Others suffer frequent fevers, nausea, and severe abdominal cramps.
Diagnosis of both major forms of IBD proceeds in a similar fashion. Blood tests are done to check for anemia, which could indicate bleeding in the intestines. Blood tests may also uncover a high white blood cell count, which is a sign of inflammation somewhere in the body. By testing a stool sample, the doctor can tell if there is bleeding or infection in the intestines. A colonoscopy allows for visual examination of the intestines and will reveal the inflammation, bleeding, or ulcers that characterize IBD. Sometimes x-rays or CT scans are also employed for diagnosis.
Control is the goal
Treatment of IBD strives to control inflammation, correct nutritional deficiencies, and relieve symptoms. A wide range of medications is utilized to reduce the number of times a person experiences a flare-up of symptoms, but at this time there is no cure for IBD. Some people have long periods of remission, sometimes years, when they are free of symptoms. However, the disease usually recurs at various times over a person’s lifetime.
About 25% of patients with ulcerative colitis will eventually require surgery because of massive bleeding, severe illness, rupture of the colon, or risk of cancer. About two-thirds of patients with Crohn’s disease will require surgery to relieve symptoms that don’t respond to medical therapy or to correct complications such as blockage, perforation, abscess, or bleeding in the intestine. People with inflammatory bowel disease may feel well and be free of symptoms for substantial spans of time when their disease is not active. The disease can be emotionally taxing, yet despite the need to take medication for long periods of time and occasional hospitalizations, most people with IBD are able to hold jobs, raise families, and function successfully at home and in society.