May is Digestive Health Month, making it a great opportunity to raise awareness and encourage education around digestive health issues, a topic that can be uncomfortable for many to talk about. 

We are placing a focus on two common digestive issues, Irritable Bowel Syndrome (IBS) and Irritable Bowel Disease (IBD). These are two conditions that are easily mixed up or even often confused as being the same disorder, when in fact they are distinctively different. Let’s take a look at the key differences between IBS and IBD and how we can distinguish one from the other. 

Irritable Bowel Syndrome 

IBS is a digestive condition that is thought to affect as many as 1 in 5 people in Ireland. It is most common in people in their 20s and 30s, and seems to be more prevalent in women than men. For some people IBS is a mild annoyance, while for others it can be completely debilitating and affect their quality of life.

Common Symptoms

The main symptoms of IBS are:

• Abdominal pain and cramps (pain may be worse after eating and relieved following a bowel movement)
• Bloating
• Diarrhoea
• Constipation

Other symptoms include:

• Excessive belching and flatulence 
• Urgent bowel movements
• Passing mucus 
• Joint pain
• Fatigue
• Nausea
• Incontinence 

People living with IBS may find that their symptoms are worse on certain days and can be triggered by certain foods or drinks.

Causes

The exact cause of IBS is still unknown. It appears to occur due to an abnormal response of the muscles in the intestinal walls. The walls of the intestines are lined with muscles that contract to move food through the digestive tract. Contractions that are stronger and last longer than usual can cause pain, nausea and diarrhoea, while weak contractions can slow food passage and lead to gas, bloating and constipation. However, it is not known what causes this to happen. 

IBS has been linked to things like:

• Family history of IBS
• Oversensitive nerves in the gut 
• Stressful or difficult events in early life
• Certain mental disorders such as depression and anxiety
• Bacterial infections in your digestive tract or food poisoning
• Changes in gut microbes

It is thought that a combination of problems may lead to the development of IBS, and that different factors may be responsible for causing IBS in different people.

Triggers

IBS flare-ups can happen for no obvious reason, or you may notice symptoms can be triggered by:

• Diet - some people experience IBS symptoms when they consume certain foods or drinks. These commonly include wheat, dairy products, greasy foods, citrus fruits, beans, cabbage, milk, carbonated drinks, caffeine and alcohol
• Stress - many people report worse or more frequent symptoms during times of increased stress or anxiety 
• Hormonal changes - changes in hormones have been seen to affect IBS symptoms with some people experiencing worse symptoms at certain times during the menstrual cycle and after menopause

Treatment

There are no tests for IBS, and your doctor will generally make a diagnosis on the basis of your symptoms and after ruling out various other disorders. You may need some medical tests to rule out these other disorders such as blood tests and stool analysis. 

Unfortunately, there is no cure for IBS and treatment generally focuses on relieving symptoms. Mild symptoms can often be controlled by managing stress and making changes to your diet and lifestyle. Doctors may recommend:

• Avoiding foods that trigger symptoms
• Making certain dietary changes 
• Drinking plenty of fluids
• Exercising regularly
• Finding ways to relax 
• Getting quality sleep

There are also various medications that your doctor might recommend, some of which are available over the counter. 

If your problems are more severe, your provider might suggest mental health therapies, especially if you have depression or if stress tends to make your symptoms worse.

Don’t get disheartened if you don’t find relief right away. You may have to try a few treatments to find what works best for you. 

Inflammatory Bowel Disease 

IBD can cause some of the same, painful symptoms as IBS, but it is a very different condition. IBD is caused by long-term inflammation of the intestines. The two most common types of IBD are:

• Crohn's disease: This type of IBD is characterised by inflammation of any part of the gut, from the mouth to the anus. The most common area affected is the small intestine.
• Ulcerative colitis: This condition involves inflammation of the large intestine and rectum, and often results in sores on the intestinal lining. 

It is thought that at least 40,000 people are living with IBD in Ireland with males and females affected equally. It develops most commonly between the ages of 15 and 35, and can also be common in people aged 50-70.

Common Symptoms

The main symptoms of IBD are: 

• Diarrhoea that lasts for several weeks
• Abdominal pain and cramping
• Blood or mucus in stool
• Fatigue
• Reduced appetite
• Unintended weight loss 

The severity of IBD symptoms vary from person to person, depending on the level of inflammation and where it occurs. It is common to have active phases when symptoms worsen followed by periods of remission.

Symptoms of IBD are more severe than IBS, and unlike IBS, if IBD is left untreated it can lead to complications which may become life threatening. 

Causes

The exact cause of IBD remains unknown, but it occurs due to an immune system malfunction. In people with IBD, instead of protecting the body, the immune system attacks the bowel causing it to become inflamed. However, it is not clear why this happens. 

There does appear to be a genetic component to IBD as it is more common in people who have family members with a medical history of IBD.

Treatment

An IBD diagnosis typically involves a combination of endoscopy (for Crohn’s disease) or colonoscopy (for ulcerative colitis) and imaging studies, as well as stool samples and blood tests.

There is no cure for IBD. It is a chronic condition that requires long-term management, and treatment typically aims to improve symptoms by reducing the inflammation that triggers them. 

Treatments for IBD include:

• Medicines such as anti-inflammatory medication and steroids
• Surgery may be required if symptoms are severe

While there is no one particular diet that works for everyone with IBD, it is recommended to try to eat a healthy, balanced diet and stay hydrated. It can be helpful to notice what your body tolerates and what it doesn’t - the best foods are the ones that work for you. Exercise can also be beneficial, however it is important to listen to your body. During flare-ups, if you can’t exercise as you normally would, consider switching to low-impact exercise such as walking or yoga. And it’s okay if your symptoms aren’t allowing you to exercise, you can always pick it back up when you feel better.

IBS vs. IBD

Despite the similarities between IBS and IBD they are two very different conditions. 

• IBD involves inflammation of the gut whereas IBS does not
• Symptoms of IBD are often more persistent and more severe than IBS symptoms
• IBD flare-ups can be associated with certain foods and stress but these triggers are more closely linked to IBS flare-ups 
• There is a risk of life threatening complications with IBD that is not present with IBS

Digestive health supplements may have a beneficial effect on symptoms of IBS and IBD, in conjunction with prescribed treatments. Symprove is a water based digestive health supplement that contains millions of gut friendly bacteria and can be included as part of a healthy diet. Due to Symproves water based formulation, it arrives in the gut without triggering digestion, allowing the bacteria to thrive and bring balance to the gut microbiome. Symprove is taken as a 70ml shot each morning, at least 10 minutes before eating or drinking.

Always consult a healthcare professional before taking a new supplement if you are on medication or have any underlying conditions. If you are looking for more information on IBS, IBD or gut health in general, please reach out to our expert pharmacy team today.