Crohn's disease and irritable bowel syndrome: why are they similar?

Are you losing weight rapidly? Do you have digestive problems but don't know what's wrong? Is your medical treatment ineffective? You could be suffering from inflammatory bowel disease or irritable bowel syndrome, two very different conditions that can be confused. We'll show you the differences.

Inflammatory bowel disease (IBD) includes Crohn's disease and ulcerative colitis. Both are autoimmune diseases characterized by an impairment of the body's ability to digest food and absorb nutrients, with symptoms that appear intermittently, in episodes.

Irritable bowel syndrome (IBS) is a functional digestive disorder characterized mainly by variability in bowel movements. Its causes are unclear, but it is believed to be linked to problems in the gut-brain connection, as IBS is associated with difficult and traumatic events in childhood and psychological problems such as anxiety and depression. On the other hand, a bacterial infection or food intolerance could also be causing this condition.

Why can IBD and IBS be confused?

There are a number of criteria that make differential diagnosis difficult, although, as we always say, a good understanding of the clinical picture, the patient's history, and their genetic and environmental factors can help us make an effective diagnosis.

• Both diseases, IBD and IBS, manifest with similar symptoms: diarrhea, changes in bowel movements, and abdominal pain. It is precisely these differential symptoms that a specialist must focus on when making a diagnosis. For example, weight loss is a symptom that can lead us from a diagnosis of IBS to IBD, as can anemia, blood in the stool, fever, or joint pain.

• It is common to find overlapping symptoms of both diseases. In other words, the two diseases coexist but must be treated differently, especially if we focus on the causes of these diseases rather than their symptoms.

In this regard, it is particularly important to carry out very specific tests such as those performed by Biosalud Análisis. From a biological medicine perspective, we try to find the cause of diseases using a wide range of tests, which allows us to apply therapies that act on all aspects influencing the disease.

• There is a genetic basis that may be common to both diseases.

• In both cases, acute gastritis can trigger the disease.

• IBS, like IBD, can cause tissue inflammation —more typical of an autoimmune disease. As stated in the report "Is there a connection between inflammatory bowel disease and irritable bowel syndrome?" by Dr. A. Viejo – Almanzor, "an increase in inflammatory cells has been demonstrated in the intestinal mucosa of patients with IBS and, more specifically, an increase in mast cells in the jejunum and colon and in CD3 and CD25 intraepithelial lymphocytes in the colon has been observed. In addition, an increase in activated mast cells has been observed in the vicinity of nerve endings in patients with IBS."

On the other hand, there are some fundamental differences between the two diseases. The first is the autoimmune nature of IBD, which can trigger more serious symptoms and complications than IBS. Diet and lifestyle changes can be decisive in IBS, but not in IBD, where treatment is much more complex and is based on reducing inflammation in the digestive tract.

Diet as the basis for treatment in both diseases

At Biosalud , we advocate personalized treatments, which involves designing a personalized diet for each individual case. With IBS and IBD, following the diet at home is a very demanding part of the treatment for the patient, but it is worth it because it is essential for regaining quality of life.

In general, we recommend physical exercise, stress management, and regular meal times and bathroom breaks. In addition, identifying food sensitivities or intolerances is essential.

• With IBS, we should moderate our consumption of insoluble fiber (whole grains, spinach, lettuce, broccoli, etc.) and increase our consumption of soluble fiber (oats, barley, apples, carrots, legumes, and citrus fruits) through food and dietary supplements. In addition, hydration should be improved by drinking water and herbal teas. "Irritating" foods such as gas, spicy foods, coffee, and tea should be eliminated from the diet.

• In the case of IBD (Crohn's disease and ulcerative colitis), although a diet that completely restricts certain foods is not highly recommended, foods that increase inflammation, such as sugar, refined foods, and alcohol, should be avoided. On the other hand, we can increase our consumption of easily digestible foods such as cereals without added sugars and non-whole grains, potatoes, eggs, lean meats, legumes, vegetables, and rice or oat-based drinks.

The way food is cooked is important; the simpler the better (steaming, baking, papillote, grilling, or gentle stewing).

 Crohn's disease and cancer

Crohn's disease is a risk factor for cancer, especially adenocarcinoma of the small intestine. However, this condition is not only linked to tumors, but also to the medications used to treat Crohn's disease and inflammatory bowel disease, such as thiopurines, which increase the risk of lymphoma by four to five times.

On the other hand, when Crohn's disease affects the lower part of the large intestine, the colon, the risk of colon cancer increases. That is why it is advisable to have a colonoscopy—the most effective technique for detecting colon cancer—every year or every two years. This way, areas of dysplasia, which precede the appearance of cancer cells, can be detected, and the onset of cancer can be prevented in time.