Disease or syndrome? What is the difference between bowel disorders that affect children?

You’re not alone if you find the terms “inflammatory bowel disease” and “irritable bowel syndrome” confusing. And the fact that most doctors refer to these two conditions as a jumble of letters – IBD and IBS – doesn’t help matters. Both disorders affect the body’s gastrointestinal (GI) tract or digestive system. Both IBD and IBS can have overlapping symptoms, like belly pain or diarrhea. And I often find that both terms are sometimes used as a blanket term to describe specific symptoms or even used interchangeably.

IBD versus IBS – what Is the difference?

But IBD and IBS ARE two very distinct gastrointestinal (GI) disorders. Every day I talk to pediatric patients and their parents who come to my GI clinic for answers. Their questions and concerns may stem from the struggle to figure out what is going on with their child or the worry about persistent symptoms. Their child’s symptoms may be worsening and starting to impact school and other activities of daily life.

I find that educating patients and their families is an essential part of the diagnosis and treatment process for managing both IBD and IBS. Let’s start here with a breakdown of both conditions.

Inflammatory Bowel Disease, or IBD

IBD is considered a rare disease, affecting only 0.1% of children. IBD is also an autoimmune disease, which means your immune system wrongly attacks a part of the body. Two of the most common GI autoimmune conditions we diagnose and treat are Crohn’s Disease (inflammation that can affect the whole GI tract) and Ulcerative Colitis (inflammation is limited to the large bowel).

Common symptoms of IBD in kids

The inflammation of IBDs affecting your child’s GI tract can range from mild to severe. Over time, chronic inflammation can damage the health and function of the body’s digestive organs. Your child’s pediatrician may recommend that a child be evaluated at our clinic to rule out IBD if symptoms include:

• Ongoing belly pain
• Blood in the stool
• Poor bowel health, including diarrhea, bloating, & nausea
• Leveling of growth & lack of pubertal development

Currently, there is no cure for IBD. But suppose your child is diagnosed with IBD. In that case, we use effective treatments to stop and control gut inflammation, manage the symptoms, and improve the overall quality of life.

Irritable Bowel Syndrome, or IBS

Most kids who exhibit symptoms like diarrhea, constipation, bloating, gas, and abdominal pain have IBS. As with IBD, the gut is not working correctly. Both are GI disorders. And with similar symptoms, the two terms are easy to mix up. But IBS is not an autoimmune disease like I described above.

So, here’s where my job gets tricky. What is causing these symptoms in my patients, and what is the best course of treatment?

“There’s no one-size-fits-all”

Once I have ruled out IBD, getting to the bottom of an IBS diagnosis can be challenging. Research studies around IBS show that many factors affect changes in the body’s GI tract. This means that the most effective IBS treatment needs to be tailored to each individual patient.

With the help of parents and family members, I need to take the time to explore and understand every child’s unique set of circumstances and consider factors such as:

• Family history or genetics
• A significant life event, such as starting a new school, a new sibling, or the loss of a pet
• Environmental exposure(s)
• Psychological stressor(s)
• Food intolerance(s)

I know that finding the cause of IBS can be frustratingly slow. Still, we often find that a “trial and error” approach is the best way to figure out the most effective treatment for your child’s symptoms. The best treatment may end up being some combination of dietary changes, medication, stress reduction, or psychological therapy – but we’ll work together to get there.

Have questions about IBD or IBS treatment at Mary Bridge Children’s? 

Learn more at Gastroenterology, Hepatology & Nutrition Clinic. If you would like information about getting a referral to see Dr. Varier or one of our pediatric GI clinicians, please call 253-792-6630.