Diet and Health FAQ

Tagged As: Symptoms Of Ulcerative Colitis

Question:
I was wondering what the difference between Ulcerative Colitis and IBS are. What symptoms distinguish the two?  I understand that stress plays a factor in IBS but when I think of stress I also think of ulcers.  Is IBS a precursor to something like Ulcerative Colitis (in cases of extreme unrelenting stress)?I know that blood in the stool is NOT a symptom of IBS but is blood found in the stool of people suffering from Ulcerative Colitis? There are posts on this board of people who say they feel a slight pain in their left abdomen.  Is this symptom of both IBS and Ulcerative Colitis? I have read that people with IBS may feel a slight dull pain in the left side. Does this mean an ulcer is developing or has developed in the colon?

Answer:
IBS is a functional disorder.  It is diagnosed in the absence of infectious agents, absence of inflammation, etc.  Ulcerative Colitis is an autoimmune problem where the immune system attacks the colon causing inflammatory changes.  (Crohn’s is similar, but can affect any portion of the digestive tract, and also generally has more severe complications). There is no evidence that having IBS leads to either of the inflammatory diseases or cancer. There are people who can be diagnosed with both an Inflammatory Bowel Disease (IBD) and IBS, however. Usually when they continue to have symptoms even though all evidence indicates that the IBD is currently in remission.  There are also many people who have an IBD (or other problems) that are initially misdiagnosed as having IBS, the IBS didn't turn into anything else, the other problems were not initially found) This is correct.  In the IBD's the lining of the bowel is being attacked by the immune system and becomes ulcerated, and thus bleeds, occasionally quite dramatically.  IBDers on the whole tend to also have more problems with unexplained weight loss than IBSers (but weight loss is occasionally seen in IBS patients). One caveat, people with hemorrhoids (sp?) may find that when they are having IBS symptoms that that stool changes irritate things and the buggers can bleed, so some blood is not always a sign of IBD (but usually the IBS=no blood thing holds true) Pain can be a symptom of either, and pain with IBS can be quite severe (before I got effective treatment, I couldn't walk more than a few hundred feet... sometimes much less... without having the doubled over holding the sides ready to have the colon just removed and a bag installed kinda pain).   The two disorders cannot be distinguished by the type of pain, or the severity of diarrhea (constipation is rarely seen in IBD, but there's always someone who has to rock the boat.  To differentiate the two (besides copious blood loss, which is generally only seen in IBD's during a severe flare up) the doctor usually needs to take a look and see if the lining of the colon appears normal or not. The pain in the colon from IBS is caused by a spasming of the muscles, like having a charley horse in your gut. The symptoms of IBS are currently best explained by the following hypothesis.  There is a moderately independent nervous system that controls the functioning of the gut (much like there are specialized bundles of nerves that control heart rate).  This system does get input from the brain, and sends information to the brain.  With IBS something is amiss.  The regulation of movement of food through the gut can be haywire, which is generally the root of the diarrhea, constipation, or alternation of the two.  The sensory system that tells the gut control what is going on can be haywire, so that the gut misreacts to various foods, or other stimuli (like the part that senses when the stomach is expanding which normally signals a gentle move things along, while in IBS can trigger a much stronger than needed reaction).  The part of the gut control that recieves information from the brain may be misinterpreting the signals (so stress is over responded to with various reactions). Or the part of the system that sends sensory information to the brain can be messed up, so that normal sensations are greatly over-reported  (IBS patients can report rather distressing sensations). IBS can be treated with drugs (or alternatives) that focus on relieving symptoms. (antidiarrheals, antispasmodics, fiber, stool softeners,etc) Also, it often treated with low doses of antidepressants, which seem to help to re-establish normal functioning of the nerves (usually IBS patients can take less than the psychoactive dose).  Also, things like hypnotherapy, and Cognitive Behavioural Therapy can be used. Don't know about UC vs IBS, but I was told that a pain in the lower left abdomen is a sign of diverticulitis.  Re UC and IBS symptoms, they are a lot alike -- my doc told me a signoidoscope or colonoscopy could tell the difference (inflammation in different areas).  My doc insists mine is IBS, but I continue to have doubts and keep looking for someone to give me a definitive answer - lots of luck to all of us.