Tag Archives: ulcerative colitis

Differences between IBD and IBS

Both IBD and IBS can be distressing and difficult to live with, they can both cause lots of pain, discomfort and difficulty with day to day life, but there are some significant differences and its important to know what they might be so that proper diagnosis can be sort.

Firstly I want to say that anyone facing symptoms that they aren’t sure about, or anyone facing symptoms that are new or more severe than what’s considered normal for them should seek medical attention, I also want to say that any medical condition is hard to deal with, this post is not meant to play one condition against the other, my hope is to provide information that may be helpful when seeking a diagnosis, and to raise awareness of both conditions.

Symptoms

One of the easiest ways to differentiate the two conditions is to look at the potential symptoms.

IBD

Symptoms of IBD can include

  • Blood in the stool
  • Diarrhoea
  • Abdominal pain
  • Nausea
  • Vomiting
  • Constipation
  • Joint pain
  • Eye inflammation
  • Nutritional deficiencies
  • Increased inflammatory markers in blood and/or stool
  • Fatigue
  • Weight loss
  • Mouth ulcers
  • Bloating
  • Passing mucus
  • Sudden and uncontrollable bowel movements

IBS

Symptoms of IBs can include

  • Stomach pain which is often worse after eating but better after going to the bathroom
  • Bloating
  • Dirrhoea
  • Constipation
  • Flatulance
  • Passing mucus
  • Tiredness and lack of energy
  • Feeling sick
  • Trouble peeing like needing to pee often or feeling like you cannot empty your bladder properly
  • Incontinence

Blood in the stool, fever , anemia and unexplained weight loss are not symptoms of IBS, if you have these symptoms its really important that you talk to your doctor, even if you have a previous diagnosis of IBS. You also need to make sure that you tell your doctor if you have a family history of any bowel diseases or cancer, including coeliac disease and inflammatory bowel disease.

Testing

Regardless of what you think you might be suffering from, its important to see a doctor, I understand that some of these symptoms may be embarrassing for you, but it’s important to talk about them, and the doctors wont judge you, they will be used to these conversations, they won’t be surprised and they will want to help. If a doctor ever makes you feel uncomfortable, or you feel like they aren’t taking you seriously please ask to see someone else, it’s so important that you are cared for properly.

When you see a doctor, blood tests and stool samples should be taken to look for inflammation, infection and to look for blood in the stool (poo). It is also important that you have tests to look for any nutrient deficiencies, especially if you have been having trouble eating or have been loosing weight.

If these tests show there might be something that needs further treatment, you should be referred to a gastroenterologist who will organise imaging such as an MRI and possibly a colonoscopy.

Key differences

A key difference between IBS and IBD is how they impact the body internally. IBS is what’s known as a functional disorder, which means there’s a problem with the way the gut functions and this causes the symptoms, whereas in IBD, the immune system attacks healthy cells in the digestive tract, causing inflammation, scarring and long term damage.

While IBS is undoubtedly extremely difficult to live with IBS, it. Does not damage the digestive tract, it does not cause an increase in cancer risks or life threatening complications. However, if you are suffering with IBS you still deserve good care from medical services, so don’t let them turn you away

IBD causes inflammation which can do permanent damage to the digestive tract. Ulcerative colitis damages the colon and the rectum while crohns can damage any part of the digestive tract. There are also extra intestinal manifestations such as osteoporosis, eye inflammation, joint pain and there is an increased risk of some types of cancer. Left untreated, or if treatments fail, IBD can have fatal complications including a perforated bowel or a fatal infection due to the immune suppression caused by some of the treatments needed to control the disease.

It is of course possible to suffer from IBD and IBS at the same time, and there are lots of other digestive illnesses, so , whatever diagnosis you are given, please do keep fighting if you feel something isn’t right, and remember no matter what you’re told IBS does not cause inflammation, bleeding or nutrient deficiencies so if you are suffering with any of these you need to pursue a different diagnosis. It can be hard to advocate for yourself with people who you think should know more than you, but it is super important and could save your life.

World IBD Day 2024

Sunday 19 May 2024 is world IBD day,

To mark this important day I thought I would talk about IBD, the main types, symptoms, diagnosis and treatments.

IBD stands for Inflammatory Bowel Disease, it is a group of conditions that cause inflammation and damage to the digestive system. There are a few different types of IBD with the main two being Crohn’s disease and Ulcerative Colitis . The exact cause of Crohn’s disease is unknown, but it is thought that there is an auto-immune or auto-inflammatory component. One train of thought is that the immune system reacts to something in the gut – possibly bacteria- and starts to attack it, causing damage, research into the causes and mechanisms of IBD is currently on going and new theories are coming out all the time.

Crohns disease

Crohn’s disease can impact anywhere in the digestive tract from the mouth to the anus, it causes inflammation, ulceration, scarring and damage to all layers of the bowel, and it can cause complications such as fistulas which are abnormal tracts between one part of the body and another, such as between the bowel wall and the abdominal wall. In Crohn’s disease the damage can be sporadic, there can be patches of inflammation and patches of healthy tissue, which means that if you looked at only a small section of tissue, you might miss the disease and think it is not present.

Ulcerative colitis

Ulcerative Colitis (UC) impacts the large intestine (known as the Colon) and the rectum. Small ulcers develop on the lining of the colon which can bleed and produce pus. In ulcerative colitis the inflammation is continuous, and it only affects the inner most lining of the colon.

Indeterminate colitis

In about 10% of people with IBD, features of both UC and Crohn’s are present, making it impossible to distinguish between the two types of IBD, in these patients a diagnosis of inderminate colitis is made.

Symptoms

Symptoms vary from person to person and even between different flare ups in the same person. The most well known and more common symptoms include

  • Stomach pain
  • Nausea
  • Vomiting
  • Weight loss or weight gain
  • Bloating
  • Diarrhoea
  • Nutrient deficiencies
  • Bleeding from the gastrointestinal tract

While these symptoms may seem obvious for a digestive disease, there are other symptoms that may seem less obvious and these include

  • Joint pain
  • Fatigue
  • Eye inflammation
  • Mouth ulcers
  • Osteoporosis
  • Skin issues

Diagnosis

Because the symptoms mimic so many other conditions IBD can be hard to diagnose, unfortunately it often takes people a few years to get a proper diagnosis . Getting a diagnosis usually starts with speaking to a GP and getting some basic blood tests and a stool sample should be taken to look for blood, inflammation and signs of infection, there may also be a physical examination of your stomach to check for any other signs of issues,

After this, if the GP deems it appropriate, they will refer you to a gastroenterologist which is a specialist in the digestive system who may order further testing including an MRI and/or a colonoscopy or endoscopy. The best way to get a firm diagnosis is to get a biopsy of the intestine which can be done during a colonoscopy. The biopsy can help determine if you have Crohn’s or UC or if there is something else going on. Sometimes these tests will come back clear despite continuing symptoms. If this is the case, you can ask for other testing such as a barium meal follow through or a white cell scan which is a specialist scan where the white blood cells are tagged with radiation and a special scanner is used to follow them. If the white cells are seen to be concentrating in a specific area it can indicate inflammation which can be used to help with diagnosis.

Whatever tests you have, don’t give up if you are still having symptoms and feeling unwell, it’s important to stand up for yourself and not to let anyone put you off, getting a diagnosis is important for any illness, and its not ok for anyone to be left suffering.

Treatments

There is no cure for IBD, so treatment aims to control the disease and help to improve quality of life by getting symptoms under control.

Steroids

Corticosteroids like prednisolone or budesonide are used during the acute “flare” phase of the illness. A flare up is when the disease is active and causing more symptoms than the day to day baseline and steroids control these flare ups by reducing the inflammation in the digestive tract. Although they are usually very helpful and can get symptoms under control very quickly, steroids are not a long term option as they come with some quite significant risks including bone thinning, mood disturbances and the possibility of steroid dependancy.

Liquid diets

Liquid diets can be used at any age but they are most commonly used in children to give the gut a chance to rest and heal, they can also be used to try to help someone gain weight and nutrition if they have become malnourished as a result of their illness. Liquid diets use a very special form of formula food, which can be partly or fully predigested and may be highly calorific. They are tough to deal with, but they are a very low risk way of treating the inflammation and pain associated with IBD.

5 ASAs ( aminosalicylates)

These drugs have an anti-inflammatory component and they are chemically similar to aspirin, they dampen down the inflammatory process and allow the damaged tissue to heal. They are generally very safe drugs and they are often used as a first line treatment, especially in cases of IBD that aren’t very advanced or severe. The downside is they have limited effectiveness, so they aren’t appropriate for people with advanced or severe disease.

Immune suppressants

Immune suppressants work by calming down the immune system in the hope of stopping the damage to the digestive tract. The downside to immune suppressants is that they leave you more prone to infection and can have some serious side effects including liver problems, it’s important to have regular blood tests before and during treatment.

Biologics

Biologics are medications that work on the immune system and modulate it. Different Biologics work on different parts of the immune system, infliximab and adalimumab for example are both anti-tnf medications. Biologics block the part of the immune system that they are targeted at, with the aim of stopping any further inflammation from occurring. Like immune suppressants, Biologics come with a higher risk of catching infections and difficulty fighting them, they can also come with a higher risk of some types of cancer and they can lead to issues with organs such as the liver. Most Biologics are delivered by infusions or injections, the injections are usually self administered at home by the patient.

Surgery

Sometimes medication isn’t enough to stop the IBD from spreading or causing complications like abscesses and surgery can become necessary. There are a few types of surgeries that may be performed with IBD including bowel resections where a part of the bowel is removed and the healthy ends are joined together, stoma surgery where a part of the bowel is removed and the end is pulled through an opening in the abdomen, abscess lancing and removal and fistula repair surgery.

Worst case scenario

Although thankfully quite rare, people can die or be left with serious life long impacts from IBD and its complications . People with Crohn’s disease may experience a perforated bowel, which is a medical emergency or there may be complications related to surgery done to treat the IBD. People with IBD are more at risk of cancer, and some of the treatments also increase the risk of some cancers such as skin cancers, many of the treatments also reduce the function of the immune system which means patients are more susceptible to infections and may have more difficulty fighting off viruses like Covid and the flu.

This is why we need research for a cure and kinder more reliable treatments. Current treatments are much better than we had even 10 -20 years ago, but they don’t help everyone and they do have the potential to fail, and they all have potentially serious side effects. If you would like to help, just sharing information about IBD can be really helpful, the more people who know about IBD and its signs and symptoms, the better chance we have of getting people diagnosed early and stopping the worst of the damage. Increasing awareness will also increase funding as people will be more aware of the need to fundraise, and doctors becoming more aware will mean people are treated earlier and more efficiently.