IBD vs IBS

LizzieB · Sep 8, 2014

After another wasted day of 4 hours in the hospital to find out I've had no further results, no tests they wanted to do and no information whatsoever, the general DR of the medical assessment team is trying to fob me off with possible IBS.

I've had horrific pain in waves, constant dihoreha, blood and mucus in my stools, terrible fatigue, a colonoscopy that showed ulcers on my ileum, a history of Crohn's and ulcerative colitis in my family. And this pleb with no info of my medical history (as the computers were down) comes out with IBS.

His questions were, do I eat enough fibre, do I know what fibre is, and I should drink more water.

Now my vent is over, I wonder if someone could help me. I've seen someone write on here that IBS isn't a diagnosis. I'd like to know why they think that. Just so I have some fighting talk for the next time I'm faced with this and being fobbed off again.

Thanks in advance!

DJW · Sep 8, 2014

I'd also like to know why they think IBS?

How do they explain the blood and mucus?

LizzieB · Sep 8, 2014

I've no idea. Sometimes I wish someone who has actually experienced an IBD could hand out the diagnosis. All this fibre and water nonsense was really dumbing down the condition, as if I'm doing it to myself!

RickUK · Sep 10, 2014

DJW said:
I'd also like to know why they think IBS?

How do they explain the blood and mucus?

Good question, because I was told that mucus can be found in both IBS and IBD. But whenever I mentioned it to a DR they always claimed it is more an IBD type symptom. I have only ever had blood mixed with mucus, not actally mixed into the stool itself

UnXmas · Sep 14, 2014

I don't think IBS is a real diagnosis; it's what they call digestive symptoms when they haven't found a cause for them. There is no test for IBS - it's a "diagnosis of exclusion" - the diagnosis they make when nothing's shown up on tests - which implies they think tests pick up every possible disease of the digestive system that there is, so that every case of digestive symptoms which produces negative results is IBS.

IBS is also by definition not serious.

But blood is not a symptom of IBS. That doesn't mean it's IBD - the blood could be from haemorrhoids or something, but a doctor should not attribute bleeding to IBS.

How much blood do you pass and what colour is it?

Have you had a scope of your upper digestive system?

StarGirrrrl · Sep 14, 2014

Sadly unless there is clear evidence of IBD Drs are far too keen to diagnose IBS.

I too pass blood and have always needed to get up during the night.

These symptoms are taken seriously until tests are normal then it's "everyone passes blood I do myself" yes a GI told me this!

baistuff · Sep 14, 2014

Differentiating IBD from IBS can very difficult even for experienced GI folks. Though passing blood is NEVER normal, and NEVER a part of IBS, it can be associated with simple problems like hemorrhoids, divertciuloisis, AVM's. However, mucous, and even decent amounts of mucous can occur with IBS. In fact the old term for IBS was "mucinous colitis."

Mucous is simply a protective coat that the body unleashes in response to irritation. When virus invades the nasopharyngeal passages congestion and mucous production increase to help flush the virus and protect the linings of the passages. The GI system is no different. In response to infection, inflammation or irritation, the GI system will increase mucous production. so mucous with IBS is very common.

IHMO most IBD patients suffer with IBS symptoms, myself included. It makes sense. Our GI systems move via the autonomic nervous system without us needing to think about it. Any interruption or distraction to the GI tract (even a simple virus) can alter the normal GI waves (peristalsis) and causes changes in muscle movements, transit time. Certainly this is common in IBD patients. Where does IBS end and IBD symptoms begin. That's a tough one. Typically, blood is never a part of IBS. IBS usually does not cause night time problems, and usually defacation alleviates many of the IBS sxs. Of course, our GI tracts do not read the textbooks, so sometimes they will do what they will do just to spite us.

Healing and Control to all!

M.D.

RickUK · Sep 14, 2014

M.D. said:
Differentiating IBD from IBS can very difficult even for experienced GI folks. Though passing blood is NEVER normal, and NEVER a part of IBS, it can be associated with simple problems like hemorrhoids, divertciuloisis, AVM's. However, mucous, and even decent amounts of mucous can occur with IBS. In fact the old term for IBS was "mucinous colitis."

Mucous is simply a protective coat that the body unleashes in response to irritation. When virus invades the nasopharyngeal passages congestion and mucous production increase to help flush the virus and protect the linings of the passages. The GI system is no different. In response to infection, inflammation or irritation, the GI system will increase mucous production. so mucous with IBS is very common.

IHMO most IBD patients suffer with IBS symptoms, myself included. It makes sense. Our GI systems move via the autonomic nervous system without us needing to think about it. Any interruption or distraction to the GI tract (even a simple virus) can alter the normal GI waves (peristalsis) and causes changes in muscle movements, transit time. Certainly this is common in IBD patients. Where does IBS end and IBD symptoms begin. That's a tough one. Typically, blood is never a part of IBS. IBS usually does not cause night time problems, and usually defacation alleviates many of the IBS sxs. Of course, our GI tracts do not read the textbooks, so sometimes they will do what they will do just to spite us.

Healing and Control to all!

M.D.

Great answer thanks! I think it's amazing how IBS and IBD can have so similar symptoms, yet be so far apart in terms of how serious each one is. Fortunately, I haven't passed blood, other than mixed in with mucus, so I was infact given an IBS diagnosis first. Until my faecal calprotectin came back signifcantly raised (although blood was normal). MRI and colonoscopy booked so light is starting to be seen through the tunnel now!

LizzieB · Sep 17, 2014

I had a raised fecal calprotectin too. Unfortunately it didn't mean much as they've retested a couple of months later and it's normal.

I've had colonoscopy, ODG and MRI. ulcer found on ileum but biopsies don't suggest crohns apparently. I'm supposed to be having a pill cam tomorrow. Too many horror stories about it getting stuck!

They're sticking on the IBS diagnosis at the mo. I've lost 13lbs in 40 days, and have a diarrhea pattern and constant waves of pain. Albeit much duller than it was a month ago. No idea what's going on!

baistuff · Sep 17, 2014

LizzieB said:
I had a raised fecal calprotectin too. Unfortunately it didn't mean much as they've retested a couple of months later and it's normal.

I've had colonoscopy, ODG and MRI. ulcer found on ileum but biopsies don't suggest crohns apparently. I'm supposed to be having a pill cam tomorrow. Too many horror stories about it getting stuck!

They're sticking on the IBS diagnosis at the mo. I've lost 13lbs in 40 days, and have a diarrhea pattern and constant waves of pain. Albeit much duller than it was a month ago. No idea what's going on!

A visible ulcer is not consistent with IBS, and neither is that amount of weight loss. That doesn't mean you have crohn's. NSAIDs (motrin, advil, aleve aspirin) and various infections can cause ulcers. Even some colonoscopy preps can cause pseuodulcers.

I think your work up is not yet complete. Please keep in mind it can take patients a very long time "to present themselves." A lot can be going on without much to find. Common in a lot of aspects of medicine.

DEmberton · Sep 22, 2014

I was told I had IBS about 18 years ago after a couple of years of on off stomach problems. They did a gastroscopy but not a colonoscopy for some reason.

It was only after I'd lost a load of weight that I sought help again last year. I've never had any blood so I kept believing it was just IBS and the fact things had got worse was just stress. It was a bit of a mixture of shock and relief to be told I had Crohn's and that I'd need surgery.

Obviously I'll never know but I imagine it was Crohn's all along. I remember about the time it all started I had a blood test for a different reason that showed I was deficient in B12... But the Doctor didn't think it was important. Doh!

javanov · Sep 23, 2014

I have similar symptoms to my brother, who has been tested and they found raised calprotectin in his stools and suspect Crohns, he also has had frequent mouth ulcers.

Sadly, my doctor works at a snail's pace and has distanced my appointments out as far as possible, then again I have been pretty stupid and done the opposite of what I should be doing - instead of going to surgeries at my worst I've gone and seen the doctor at my best (forcibly, in order that I don't have a diarrhea attack when I@m out or anything like that, I'm a very paranoid guy about things like that). The doctor has so far concluded that I must just have "severe IBS"

Looks like a lot of us are being let down by the NHS, one of the best healthcare systems in the world they say, I blame individual doctors for not being thorough rather than the NHS though, as it's seen me through kidney problems that could have left me on dialysis in the past (having been tested for these recently, they said I still had an imbalance in kidney function that this couldn't be causing most of my symptoms). I think it's just too easy to diagnose IBS for doctors, a lazy diagnosis that doesn't cost too much money :/

javanov · Sep 23, 2014

LizzieB said:
After another wasted day of 4 hours in the hospital to find out I've had no further results, no tests they wanted to do and no information whatsoever, the general DR of the medical assessment team is trying to fob me off with possible IBS.

I've had horrific pain in waves, constant dihoreha, blood and mucus in my stools, terrible fatigue, a colonoscopy that showed ulcers on my ileum, a history of Crohn's and ulcerative colitis in my family. And this pleb with no info of my medical history (as the computers were down) comes out with IBS.

His questions were, do I eat enough fibre, do I know what fibre is, and I should drink more water.

Now my vent is over, I wonder if someone could help me. I've seen someone write on here that IBS isn't a diagnosis. I'd like to know why they think that. Just so I have some fighting talk for the next time I'm faced with this and being fobbed off again.

Thanks in advance!

Get a stool sample done, that's what I'm doing next, it's thus far worked for my brother in advancing his diagnosis

IBD vs IBS

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