"When it comes to IBS and IBD, parents can get confused because the conditions are sometimes used interchangeably, which is a mistake," says Ashish Patel, M.D., Director of the Southwestern Pediatric IBD program at Children's Health℠ and Associate Professor at UT Southwestern. "The confusion occurs because they have similar symptoms, but the treatments are very different."
What is the difference between IBS and IBD?
Both IBS and IBD are chronic GI conditions, but they affect the digestive tract in different ways.
IBD, which includes ulcerative colitis and Crohn's disease, causes areas of inflammation in the digestive tract that can be seen when examined by a doctor. Without treatment, IBD is progressive and aggressive.
"If you don't treat these areas of inflammation, your child has an increased risk of surgery, hospitalization or a great need for medications," explains Dr. Patel.
IBS, on the other hand, does not cause any visible changes or inflammation in the digestive tract. The condition occurs when the bowel becomes sensitive to foods, allergens or stress, leading to symptoms like constipation and/or diarrhea.
IBS vs. IBD symptoms
Both IBS and IBD can lead to uncomfortable GI symptoms like abdominal pain and diarrhea. These symptoms can be severe, preventing your child from attending school or participating in activities. However, there are some differences between IBS and IBD symptoms.
IBS symptoms include:
- Abdominal pain or cramping
- Constipation and/or diarrhea
- Difficulty sleeping
IBS symptoms may get worse when your child eats certain foods or is under a lot of stress.
IBD symptoms include:
- Abdominal pain or cramping
- Weight loss
- Blood in the stool
"Rectal bleeding is the biggest symptom difference between the two," says Dr. Patel. "We don't see bleeding in children with IBS."
IBD can also affect how your child absorbs nutrients. Even if your child is eating and getting nutrients from the foods they consume, their body may not take in all the nutrients it needs. Your child may lose weight or grow more slowly than other children their age.
Although both IBS and IBD are not as common in younger patients as in adults, these conditions can occur in early adolescence or begin during the teen years.
"We are now diagnosing early onset IBD in children under age 10, as well as very early onset IBD in patients under the age of 6," says Dr. Patel.
Diagnosing IBS vs. IBD in children
Because children with IBS and IBD can have similar symptoms, it's important your child's doctor gets a thorough medical history of your child's symptoms. The doctor takes a sample of your child's stool for testing. Tests may show if your child has an infection or other issues.
If your child's doctor finds blood in the stool, they may begin testing for IBD. Tests may include upper endoscopy and colonoscopy, which use small cameras to look for areas of inflammation in your child's digestive tract.
If your child doesn't have blood in their stool, the doctor may first try to rule out infections or allergies causing their symptoms. Your child may try medicines or dietary changes to see if their symptoms improve.
"Unfortunately, it is possible to have both conditions at the same time," says Dr. Patel. "One of the theories for this is that the inflammatory process has led the bowel to be hypersensitive to even small stimuli, like certain foods," he says. "So, we have to carefully evaluate if their IBD is not well controlled or if they have IBS on top of IBD."
While there is no simple cure for either condition, symptoms of IBS and IBD can be managed with proper care. IBS is often controlled with anti-spasmodic medicines, dietary changes and cognitive behavioral therapy. IBD is often treated with anti-inflammatory medications. A pediatric gastroenterologist can help determine the best treatment for your child.
At the Southwestern Pediatric Inflammatory Bowel Disease Program at Children's Health, we provide personalized treatment, helping 80% of patients achieve remission from IBD. Learn more about our comprehensive IBD program.
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