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IBS vs IBD. What is the Difference?

Published date: January 12, 2023 | Modified date:
by Dr Stephen Wangen

Here’s what we’re going to cover

  1. The Difference Between IBS and IBD
  2. Diagnosing IBS vs IBD
  3. IBS Symptoms vs IBD Symptoms
  4. How To Tell If You Have IBS vs IBD
  5. Can You Have IBS and IBD At The Same Time?

What is the difference between IBS vs IBD?  They sound almost the same, and there are many similarities, but also some key differences. Let’s explore IBS and IBD and create clarity around each one.

The Difference Between IBS and IBD

IBS stands for Irritable Bowel Syndrome.1 IBD means Inflammatory Bowel Disease. The names can be very confusing because they sound similar and there is a significant amount of overlap between the symptoms of these two conditions.4 Both can also be considered diseases. And both can include inflammation.5 However, you want to make sure that you are using the proper terminology when referring to these conditions, because they really are two different conditions.

Diagnosing IBS vs IBD

The Difference Between IBS and IBDThe key to separating these two conditions occurs when you have a colonoscopy, usually with a gastroenterologist. A colonoscopy is the process of having a colonoscope, a long flexible tube not unlike the cable you’ve seen for cable tv, stuck up your rear end. Only in this case the cable has a light and a camera on the end of it.

During a colonoscopy your doctor can see what the inside of your colon looks like, as well as take biopsies (a tissue sample). If your colon is significantly damaged, meaning that there are visible ulcerations in there, or severe inflammation is seen in the biopsy, then you are likely to be diagnosed with IBD – Inflammatory Bowel Disease.  If there is no big obvious damage (no ulcerations), then you are likely to be diagnosed with IBS – Irritable Bowel Syndrome.

IBS Symptoms vs IBD Symptoms

IBS and IBD can both cause diarrhea, abdominal pain, constipation, gas or bloating.  IBD often includes weight loss and fatigue, but those symptoms may also be found in IBS. The key difference with IBS vs IBD is that IBD will often cause bloody diarrhea, whereas IBS will only rarely include blood in the stool. The blood from IBD comes from the ulcerations that my be seen during the colonoscopy.

What people often perceive about the severity of IBS vs IBD is that IBD is always worse. However, that is not necessarily true and is relative to the person experience either IBS or IBD, because either one can send you to the emergency room.  And the severity of the symptoms for both IBS and IBD run the spectrum from very mild to very severe. And mild cases of IBD can be far less severe than bad cases of IBS.

How To Tell If You Have IBS vs IBD

The only way to know for sure if you have IBS or IBD is to see your gastroenterologist and have a colonoscopy. There is no definitive test or way to tell the difference without a colonoscopy. Even if you have a lot of blood in your stool, there are many other things that can cause that. And your doctor won’t know the diagnosis until they do a colonoscopy.

If you do have IBD, depending on where the ulcerations are occurring, you can have either one of two types of IBD.  The two different types of IBD are Crohn’s disease and Ulcerative Colitis.

Can You Have IBS and IBD At The Same Time?

Can You Have IBS and IBD At The Same Time? You can in fact have both IBS and IBD at the same time.3   If you have both, the IBS component is often not diagnosed until your IBD goes into remission. When this happens, the ulcerations are no longer seen in your colon. However, if you are still experiencing digestive symptoms, then the question is why?  In that case, you may also have IBS.

Having both IBS and IBD probably happens far more often than is realized, because it can be difficult to separate the two, especially when the IBD is mild or in remission. It’s always smart to see an IBS specialist and get that aspect treated and solved, because it may end up helping you with your IBD.  At the IBS Treatment Center we’ve often found this to be true, so we encourage you to schedule an appointment.

Although it has long been thought that having IBS does not lead to IBD, but recent research suggests that it can and that they are two different points on a spectrum of digestive disorders.2   Either way, there is a great deal of hope for people suffering with IBS or IBD. Conventional medications tend to treat only the symptoms, which can be important in the the short term, but dealing with the underlying ecosystem of the digestive tract can lead to a much better outcome and more long-term relief.

Do you have IBS or IBD?  If so, what are you doing for it?


  2. Spiller, R., Major, G. IBS and IBD — separate entities or on a spectrum?. Nat Rev Gastroenterol Hepatol13, 613–621 (2016).
  3. Abdul Rani R, Raja Ali RA, Lee YY. Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place. Intestinal Research. 2016 Oct;14(4):297-304.
  4. Halpin, Stephen J MBChB1; Ford, Alexander C MBChB, MD, MRCP1, 2. Prevalence of Symptoms Meeting Criteria for Irritable Bowel Syndrome in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis. American Journal of Gastroenterology: October 2012 – Volume 107 – Issue 10 – p 1474-1482
  5. Ng QX, Soh AYS, Loke W, Lim DY, Yeo WS. The role of inflammation in irritable bowel syndrome (IBS). J Inflamm Res. 2018 Sep 21;11:345-349.