Do I Have Crohn’s Disease Or IBS? I have had this weird abdominal pain off and on with episodes of diarrhea for the past three months. In addition, I have lost a significant amount of weight although my diet has not changed much.
My scans show abdominal lymphadenopathy and colon wall thickening. I have been previously labeled to have depression and IBS until this new doctor told me to get investigated.
I am worried as Crohn’s disease and cancer are a few of the diagnoses my doctor has in mind now. Can my symptoms be explained if I have IBS?
Do I Have Crohn’s Disease Or IBS?
Crohn’s disease and IBS are two gut-related conditions. Crohn’s is a serious inflammatory condition while IBS is a benign condition more closely linked with depression and fibromyalgia.
However, some of the symptoms and signs of Crohn’s disease and IBS can be the same, and people are often misdiagnosed with IBS initially and later labeled as having Crohn’s disease.
IBS and Crohn’s Disease:
When a person or physician is talking about gastrointestinal diseases, you might end up hearing a bunch of terms like IBD or IBS. Both of these terms are confused with each as they sound a little similar.
Irritable bowel syndrome is a non-inflammatory disorder, whereas chronic inflammatory bowel disease, sometimes known as IBD, includes both Crohn’s disease and ulcerative colitis.
Since both of these terms are typically connected and confused, the diagnosis of each is also confused. To clear up the confusion, here are some key differences between them.
Important characteristics of IBS and Crohn’s disease
One of the most crucial points to know is that both of these conditions can show similar symptoms, however, some can be different.
These conditions can occur in anyone at any time but they tend to run in families. They can also co-occur at the same time as they both are chronic conditions.
What is meant by IBS?
Chronic stomach discomfort and irregular bowel movements are two features of the gastrointestinal tract functional condition known as irritable bowel syndrome (IBS). People with IBS frequently have normal test findings and have no clinical symptoms of a condition.
IBS manifests physically, although its causes are not yet fully understood. Currently, researchers are examining a number of probable explanations, including dietary allergies (to substances like fructose, lactose, sucrose, or gluten), an immune response to a prior illness, bacterial overgrowth, stress, or other factors.
People with IBS are classified into one of three categories based on their primary symptoms:
- Constipation and IBS (IBS-C)
- Diarrhea and IBS (IBS-D)
- IBS-mixed (IBS-M)
Although technically inaccurate, mucous colitis and spastic colitis are sometimes used to describe IBS symptoms. IBS does not lead to inflammation in the colon, unlike colitis.
What is meant by Crohn’s disease?
Inflammatory bowel disease (IBD) constitutes Crohn’s disease and ulcerative colitis. These conditions induce inflammation or swelling in the tissues in your digestive tract, this may further contribute to severe diarrhea, fatigue, exhaustion, weight loss, stomach discomfort, and malnutrition.
Patients of Crohn’s disease predominantly experience swelling and inflammation in the small intestine, however, inflammation in other parts of the intestine is also possible. This inflammation can pierce through the innermost layers of the intestines with ease.
Signs and indications of Crohn’s disease can be fatal and incapacitating as well as disturbing. Even though there is no proven cure or therapy for Crohn’s disease, medications have been found capable of reducing the symptoms and enhancing the quality of life.
With the use of such medicines, patients can experience extended remissions and lead productive lifestyles.
Variations In the Symptoms of IBS and Crohn’s disease:
As has been stated above, the symptoms of both conditions have the tendency to be identical which raises confusion and a misleading diagnosis.
Crohn’s Disease’s Symptoms:
Some signs of Crohn’s disease include:
- Abdominal pain
- Occasional constipation
- Frequent diarrhea
- Skin issues
- Blood in the stools
- Joint pain
- Weight loss
Irritable Bowel Syndrome’s Symptoms:
IBS symptoms frequently include:
- Stomach discomfort or cramps
- Chronic constipation
- Constipation and diarrhea alternate, with frequent diarrhea feeling like you can’t “complete” a bowel movement.
- Stool mucous
- Stomach gas
- Large or bloated stomach
- Post-meal nausea
Note: IBS sufferers frequently report worsening symptoms around their menstruation.
Factors That Cause IBS & Crohn’s Disease
The causes of both IBS and Crohn’s disease are still under study, here some causes are stated that may induce either of the diseases.
Causes of Crohn’s Disease:
While the main or exact cause of Crohn’s disease is still unknown, factors like dietary patterns and stress were considered the culprit previously.
With the advancement in science and research, doctors have found out that these factors only exacerbate the condition rather than cause it. Many other factors play a part in this scenario. [Ref]
For years, genes are known to play a role in making people susceptible to Crohn’s disease as this has been known to run in families. On another note, a lot of people with Crohn’s disease do not have any relative who is affected by the disease.
There is a high possibility for a virus or bacterium to trigger Crohn’s disease. Scientists and doctors have still not identified such a trigger yet.
In cases where your immune system has to fight back a foreign organism or some other environmental trigger like extreme heat or extreme cold, an unusual immune response is induced by the immune system to attack the cells in the GIT as well.
Causes of Irritable Bowel Syndrome:
Similar to Crohn’s disease, the full cause of irritable bowel syndrome is still not understood. Even though researchers believe that irritable bowel syndrome (IBS) is exacerbated by stress, however, this syndrome is in fact caused by an imbalance between the brain and the gut.
This is how the gut and the brain work in synergy:
- The gastrointestinal tract is handled by a complicated system of motor and sensory nerves that exchange information with the brain and spinal cord.
- When the colon receives information, it responds by secreting fluid or mucus and tightening or relaxing its muscles.
- While absorbing water and nutrients to make the stool that is passed in a bowel movement, the colon’s muscular contractions throughout the regular digestion process carry food through to the rectum.
- The stool is generally expelled through coordinated contractions of the muscles in the colon, sphincters, and pelvis.
Colon motility patterns are frequently abnormal in IBS patients, indicating that the required muscle contractions are not occurring as they should.
The word “irritable” refers to the exceptional sensitivity and activity of the nerves that regulate the muscles of the gut as well as the nerve endings that line the lining of the intestine.
Regular triggers including certain meals, stress, hormonal fluctuations, and specific drugs can cause IBS symptoms.
Your bowel movement may be delayed by the spasms, and if the stool loses too much water in the colon, constipation may result.
By rushing the stool through your intestines too quickly so that the fluid cannot be absorbed, spasms can also result in diarrhea.
How To Diagnose IBS and Crohn’s Disease?
Both conditions manifest with diarrhea and alternating bowel movements. IBS is a clinical diagnosis and can be diagnosed based on symptoms while Crohn’s disease is an inflammatory condition.
Crohn’s disease also called Crohn’s colitis is inflammation of the colon. It is diagnosed with the help of scans and colonoscopy.
Irritable Bowel Syndorme:
IBS is not diagnosed by testing, although doctors may use test findings to rule out other diseases. Instead, the following criteria are typically used to diagnose IBS:
- Family history and medical history
- Symptom report from a medical checkup ruling out other disorders
The diagnosis of IBS is made using the Rome IV criteria form.
According to these criteria, a diagnosis may only be established once a person has experienced symptoms for at least 1 day per week for the previous 3 months and for at least 6 months prior to that.
According to the Rome IV criteria, IBS is diagnosed when a person has recurrent abdominal pain at least once a week for the last three months and two or more of the following symptoms:
- Abdominal symptoms are linked to defecation.
- Abdominal symptoms are associated with a change in the frequency of defecation
- The apparent look of your stools has changed
IBS is frequently only diagnosed after a number of other illnesses and ailments have been ruled out. Your IBS diagnosis may occasionally take weeks or even months since testing for other disorders can be a time-consuming process.
A GP could suggest testing with a gastroenterologist to rule out Crohn’s disease if they suspect you may have it.
You could have tests like:
- A thin, flexible tube with a camera at the end is put into your bottom during a colonoscopy to check for intestinal inflammation.
- During a colonoscopy, a small sample of your gut is extracted and examined for indicators of Crohn’s disease.
- a CT scan or an MRI – You could first consume a specific beverage to help your gut appear clearly on the scan.
The following table summarizes the differences between Crohn’s disease and IBS:
|What is it?||Functional disorder||Inflammatory disorder|
|What causes it?||A disorder of abnormal gut-brain axis||Inflammation of gut mucosa|
|Symptoms||Diarrhea, constipation, or alternating bowel habits with a sense of incomplete evacuation.
Blood and mucous are absent. Weight loss is usually not a feature.
|Diarrhea or alternating bowel habits with mucous and blood in stools, abdominal pain, weight loss, fever, and symptoms of malabsorption|
|ESR, CRP, and Inflammatory markers||Normal||Abnormal (elevated inflammatory markers)|
|Treatment||Antidepressants, symptomatic treatment||Anti-inflammatory drugs and Biologics|
|Long-term disabilities||None other than psychiatric problems||Fistulas and abscesses, gut adhesions, malabsorption|