Is Inflammatory Bowel Disease (IBD) the same as Irritable Bowel Syndrome (IBS)?

You may have heard of irritable bowel syndrome (IBS) and wondered if it is the same as IBD. While often confused because their names are similar and their symptoms can seem comparable, the two are not the same.

Yes, both diseases affect the digestive tract. However, with inflammatory bowel disease, inflammation is the key characteristic. In irritable bowel syndrome it is thought that problems arise because of changes to bowel function or the way the brain senses what is going on in the bowel; inflammation does not play a role. It is possible to have IBS if you have been diagnosed with IBD. It is also possible to have just one or the other.

Does stress cause IBD?

Researchers do not know the cause(s) of IBD, but they DO know that stress is not one of them. Stress however, can aggravate your symptoms and possibly trigger a flare-up, in conjunction with a number of other factors.

The reverse is also true; IBD can cause stress. In other words, the presence of fatigue, gut pain, diarrhea, and sleep disturbances from having to get up during the night to go to the bathroom, can be stressful. As well, fatigue can be the result of the disease process itself and not just sleep disturbances.

What is ulcerative colitis?

Ulcerative colitis (UC) belongs to a group of conditions known as inflammatory bowel diseases (IBD)

UC is a chronic inflammatory condition of the colon (large intestine) that often occurs in teenagers and young adults, but also can occur in older individuals. The symptoms can include abdominal pain, bowel urgency, diarrhea, and blood in the stool. The inflammation begins in the rectum and extends up the colon in a continuous manner. While there is currently no known cure, there are many effective therapies to keep the inflammation under control.


When reading about inflammatory bowel diseases, you need to know that ulcerative colitis is not the same thing as Crohn’s disease, another type of IBD. The symptoms of these two illnesses are quite similar, but the areas affecte  in your body are different. Crohn’s disease may affect any part of the gastrointestinal (GI) tract, but ulcerative colitis is limited to the colon—also called the large intestine. Crohn’s disease can also affect the entire thickness of the bowel wall, while ulcerative colitis only involves the innermost lining of the colon. Finally, in Crohn’s disease, the inflammation of the intestine can “skip”—leaving normal areas in between patches of diseased intestine. In ulcerative colitis, this does not occur. In only 10 percent of cases are there overlapping features of both ulcerative colitis and Crohn’s disease, a condition called indeterminate colitis.

Will it ever go away?

No one knows exactly what causes ulcerative colitis. Also, no one can predict how the disease—once it is diagnosed—will affect a particular person. Some people go for years without having any symptoms, while others have more frequent flare-ups, or attacks, of their disease activity. However, one thing is certain: ulcerative colitis is a chronic condition.


Chronic conditions are ongoing situations. They can be controlled with treatment, but not cured. That means that the disease is a long-term condition. In fact, most medical illnesses, such as diabetes, high blood pressure, and heart disease, are successfully treated but not cured. Occasionally, people may develop severe complications that can be serious—such as colorectal cancer—but this occurs in a very small number of people afflicted with IBD. Studies show that people with IBD usually have the same life expectancy as people without IBD. It is important to remember that most people who have ulcerative colitis lead full, happy, and productive lives.

Who gets ulcerative colitis?

Approximately 1.4 million Americans have either ulcerative colitis or Crohn’s disease.

That number is almost evenly split between the two conditions. Here are some quick facts and figures:

  • About 30,000 new cases of Crohn’s disease and ulcerative colitis are diagnosed each year.
  • On average, people are more frequently diagnosed with ulcerative colitis between the ages of 15 and 25, although the disease can occur at any age.
  • Males and females appear to be affected equally.
  • Men are more likely than women to be diagnosed with ulcerative colitis in their 50s and 60s.
  • While UC can affect those from any ethnic background, Caucasians develop it more than other groups. It is especially prevalent among the Eastern European Jewish population.
  • Both ulcerative colitis and Crohn’s disease are diseases found mainly in developed countries, more commonly in urban areas rather than rural ones, and more often in northern climates than southern ones. However, some of these disease patterns are gradually shifting. For example, the number of cases of IBD is increasing in developing parts of the world, including China, India, and South America.

The genetic connection

Researchers have discovered that ulcerative colitis tends to run in families. In fact, the risk of developing IBD is between 5.2 percent and 22.5 percent for first-degree relatives of an affected person. It is also dependent on which family member has IBD, ethnicity, and the type of IBD—either Crohn’s disease or ulcerative colitis. Your genes clearly play a role, although no specific pattern of inheritance has yet been identified. That means that right now there is no way to predict which, if any, family members will develop ulcerative colitis.

What causes ulcerative colitis?

No one knows the exact cause(s) of the disease.

One thing is certain: Nothing that you did made you get ulcerative colitis. You didn’t catch it from anyone. It wasn’t anything that you ate or drank that brought the symptoms on. Leading a stressful lifestyle didn’t bring it on. So, above all, don’t blame yourself!


What are some of the likely causes? Most experts think there is a multifactorial explanation. This means that it takes a number of factors working in combination to bring about ulcerative colitis. The three leading factors suspected of contributing
to UC are:

  1. Environmental
  2. Genetic
  3. An inappropriate reaction by the body’s immune system

It’s likely that a person inherits one or more genes that make him or her susceptible to ulcerative colitis. Then something in the environment triggers an abnormal immune response. (Scientists have not yet identified the
environmental “trigger” or “triggers.”) Whatever the trigger is, it prompts the person’s immune system to “turn on” and launch an attack in the large intestine. That’s when the inflammation begins. Unfortunately, the immune system doesn’t “turn off,” so the inflammation continues, damaging the lining of the colon and causing the symptoms of ulcerative colitis.

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