Irritable bowel syndrome and Inflammatory bowel disease ( in early stages ) can have similar clinical presentation with symptoms like abdominal pain and diarrhoea. Symptoms worsen before or after defecation.
According to Dr K. S. Somasekhar Rao, MD, DM, Senior consultant gastroenterologist and Hepatologist, in the present era where we are seeing a rise in the incidence of IBD, we should be able to differentiate these two with utmost care.
What is the difference between Irritable Bowel Syndrome and Inflammatory Bowel Disease?
Irritable bowel syndrome is a functional bowel disease where you don't see any structural problem anywhere in the gut. It's a complex disorder presenting as pain abdomen and either diarrhoea or constipation. The cause can be a combination of abnormal eating habits, underlying psychological issues, following an episode of gastrointestinal infection, excessive stress or anxiety.
Inflammatory bowel disease is a structural abnormality in the gastrointestinal walls which can range from small erosions to large ulcers in the gastrointestinal tract.
IBD is classified into Ulcerative colitis ( involvement is seen only in the large intestine or Colon ) and Crohn's disease ( involvement can be anywhere from oral mucosa to the anal canal)
The presentation can vary from abdominal pain, diarrhoea, bloody stools, weight loss and loss of appetite.
Any person of any age group should be evaluated thoroughly when they present with symptoms of abdominal pain and diarrhoea.
Differentiating these two disorders plays a very important role in treatment.
Diagnosing Crohn's disease or ulcerative colitis can be delayed many times if not investigated properly. Identifying IBD at an early stage helps in preventing multiple complications.
Clinical symptoms, Examination findings and initial laboratory tests ( CBC, CRP, faecal calprotectin ) may help in differentiating IBS and IBD. A high level of suspicion from the physician's side helps a lot in conducting these initial investigations.
If there is the slightest suspicion of IBD, further investigations like Ileocolonoscopy should be done to make an appropriate diagnosis.
Ileocolonoscopy helps us visualise the abnormalities inside the intestine and helps us take biopsies to make a confirmed diagnosis of IBD. Ultimately it is the biopsy and histopathological examination which gives the final diagnosis of IBD.
In India Intestinal tuberculosis and many other intestinal infections also may be diagnosed when investigated for the above symptoms. Small intestinal Crohn's may require a few investigations like CT enteroclysis or small bowel enteroscopy to make an early diagnosis.
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