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What’s the difference between IBD and IBS?

When children have chronic troubles with their digestive system and parents start looking for answers, they often get confused between Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). While many of the symptoms of these two conditions are similar, there’s actually a large difference between the two. These differences also include how each is diagnosed and treated.

Inflammatory Bowel Disease (IBD)

As its name implies, IBD is a disease that causes inflammation. There are two major types of IBD: ulcerative colitis, which affects the colon, and Crohn’s disease, which can affect any part of the digestive system. IBD is idiopathic, meaning its cause is unknown. There is some reason to believe that the condition is an immune reaction that makes the body attack its own digestive system, sometimes causing permanent damage. Although the range and severity of symptoms vary from child to child, IBD can be a very serious and debilitating condition.

Irritable Bowel Syndrome (IBS)

As its name implies, IBS is a syndrome affecting the bowel. IBS is not a disease. Rather, it’s a collection of symptoms. It doesn’t cause inflammation and does not damage the digestive system. IBS is considered a so-called ‘functional disorder,’ meaning that the digestive system looks normal but is not working as it should. The cause of IBS is also unknown but stomach infections, stress, some foods, and medicines can trigger symptoms. While not as serious as IBD, IBS can also profoundly affect children.

Symptoms

As mentioned above, many of the symptoms of both conditions overlap. Diarrhea, bloating, stomach pain, and cramping are common to both. Changes in bowel movement routine, for example, periods of relatively normal bowel movements, followed by flare-up bouts of diarrhea, then back to normal, also occur in both.

IBS sufferers tend to get symptom relief after bowel movements. It is not known to lead to other conditions. IBD, however, is associated with weight loss and other potentially harmful complications such as malnutrition and poor growth in children.

Diagnosis

Do not try to diagnose either of these conditions yourself. If your child chronically has these symptoms, you should see your family doctor. You may in turn be referred to a paediatric gastroenterologist, which is a physician specializing in digestive system conditions. Diagnosis is often a case of ruling out other disease. It’s rather like Sherlock Holmes’ method of eliminating the impossible to arrive at the solution.

Keeping a detailed diary

One thing you can do is to keep track of what your child eats when they eat it. Also keep track of other lifestyle issues that you suspect may trigger  symptoms. If you have a detailed daily diary like this, it will help not only with diagnosis but also with making changes in your child's life to reduce the impact of symptoms.

A proper diagnosis is very important. This is because both conditions are treated differently.

Treatment

Managing IBS

There is no cure for IBS, but symptoms can be managed through lifestyle and dietary changes. The specifics of these changes vary from child to child. You may have to try different things to discover what works for your child. If needed, your doctor can prescribe medicines for pain and for problems with bowel movements such as diarrhea, constipation, gas, and urgency.

Managing IBD

Although lifestyle and dietary changes may also be an important part of managing IBD, additional medical intervention is usually part of treatment. Depending on the specifics of the disease, this might include anti-inflammatory drugs, a temporary liquid, or even an intravenous diet. In severe cases of IBD, surgery may be needed to remove the damaged colon (in ulcerative colitis) or a part of the small intestine (in Crohn’s disease).

For information on a new way to use technology to manage IBD, see "SickKids' first mobile app helps teens with IBD." 

Living as normally as possible

Because neither condition has a cure, the goal is to reduce symptoms to achieve a high quality of life as much as possible. It will take a little commitment no matter what your child's diagnosis is. However, with the help of a reasonable diet, possibly some other lifestyle changes, and good medical care, most children can learn to manage symptoms and lead healthy lives. Creating a diary to help identify foods and behaviours that cause symptoms will go a long way in this regard.

Cristina Cicco, RD

1/24/2011

For more information, you can reach Specialty Food Shop Dietitians with your nutrition questions by calling 1-800-737-7976 (toll-free line) Monday to Friday or by sending an e-mail to sfs.admin@sickkids.ca Or, visit our web site at  http://www.specialtyfoodshop.com

This article was created by the dietitians at The Specialty Food Shop.




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