IBS vs. IBD: The Difference Between Ulcerative Colitis, Crohn’s Disease, and Irritable Bowel Syndrome

Ulcerative colitis, Crohn’s disease, and irritable bowel syndrome (IBS) are three conditions that are often confused with one another. Crohn’s disease and ulcerative colitis are types of inflammatory bowel disease (IBD). However, IBS is a separate condition that doesn’t involve bowel inflammation. 

IBS and IBD can have similar features, so it can be difficult to know what may be causing your symptoms. A healthcare professional can help you understand the difference between IBS versus IBD and the best treatments for your symptoms. 

What is irritable bowel syndrome?

IBS is a condition where a person’s bowels tend to work differently, even though they’re normal in appearance. People with IBS often have symptoms of abdominal pain and changes in their bowel movements. 

IBS can be life-changing, but it’s not a life-threatening diagnosis. IBS doesn’t increase your risk of colon cancer, and it doesn’t cause permanent damage to the bowel lining. 

What is inflammatory bowel disease?

IBD is a group of intestinal disorders marked by chronic inflammation of the bowel. The two most common types of IBD are: 

• Crohn’s disease

• Ulcerative colitis

EXPERT PICKS: WHAT TO READ NEXT

• What’s the link between diet and irritable bowel syndrome (IBS)? Read about which foods can trigger IBS symptoms.

• Inflammatory bowel disease (IBD) and colon cancer risk: Learn more about the risk factors for colon cancer — like Crohn’s disease and ulcerative colitis.

• Understanding IBS: This guide explains the symptoms, diagnosis, and treatment for IBS.

If you have IBD, a biopsy of your bowel shows abnormal numbers of inflammatory cells and structural damage to the bowel wall. IBD also carries an increased risk of colon cancer.

What’s the difference between IBS and IBD?

IBD and IBS are very different, even though the symptoms can be similar. IBS is much more common than IBD. About 1 in 10 people have IBS. That makes IBS about 10 times more common than IBD.

Fortunately, IBS is also less serious. IBD is caused by inflammation and damage to the gastrointestinal (GI) tract. With IBS, this isn’t the case. IBS is a collection of gut symptoms caused by unusual movement and function of the bowel.

Read more like this

Explore these related articles, suggested for readers like you.

The Best Foods to Eat With Inflammatory Bowel Disease: 7 IBD Diets You Can Try

IBD Isn’t Just a ‘White’ Disease: How a Black Woman Dealt With Her Diagnosis

What Are the Worst Foods for People With IBS Symptoms? A Dietitian Explains

View more

What are the causes of IBD and IBS?

The exact causes of IBD and IBS aren’t clear. But experts have found some risk factors for each condition. 

Risk factors for IBD include:

• Family history

• Genetics 

• Certain foods (high sugar)

• Smoking (especially for Crohn’s disease) 

• Medications (like certain antibiotics and birth control pills)

• Prior surgeries (like appendectomy)

Risk factors for IBS include:

• Anxiety

• Diet

• Infections 

What are the symptoms of IBS and IBD?

Telling the difference between IBS and IBD symptoms gets tricky. Both conditions have many of the same symptoms.

Common symptoms of IBS include:

• Loose and frequent stools

• Constipation

• Abdominal cramping or pain

In addition to the symptoms above, other symptoms are more likely to suggest IBD, including:

• Weight loss

• Diarrhea at night

• Blood in your stool

• Abnormal lab tests

How do you diagnose IBD and IBS?

To make a diagnosis of IBD, a healthcare professional will first ask about your symptoms and do a physical exam. Then, you may have a combination of lab tests or imaging studies. These include:

• Blood work (like a complete blood count)

• Stool sample

• Colonoscopy (with tissue samples)

• CT scan or an MRI of your abdomen 

On the other hand, there’s no specific test for IBS. Your healthcare team will largely be able to make the diagnosis based on your symptoms. Your lab tests, imaging studies, and colonoscopy are usually normal in IBS and help to rule out other causes for your symptoms. 

What are the treatments for IBS and IBD?

Treatment is very different for IBS and IBD. If you have IBD, you’ll take medications that lower the inflammation in the GI tract. These include medications like:

• 5-aminosalicylic acids (like mesalamine)

• Steroids (like prednisone)

• Immunomodulators (like azathioprine)

• Biologic agents (like infliximab)

In severe cases of IBD, people may need surgery to remove any damaged parts of the bowel.

For IBS, a healthcare professional will focus on treating the specific symptoms you have. Changes to your diet and exercise habits are a good first step. Here are a few examples of some foods to avoid when you have IBS:

• Apples

• Asparagus

• Artificial sweeteners

• Dairy

• Soy products

• Honey

• Starches

If diarrhea is one of your main IBS symptoms, you might take medications that reduce the diarrhea, such as Xifaxan and Viberzi. If you’re more often constipated, you might take medications that help keep the GI tract moving, such as:

• Lubiprostone (Amitiza)

• Linaclotide (Linzess)

• Plecanatide (Trulance)

Stress, anxiety, or depression can worsen IBS. If these factors are playing a role, treatment options may include medications and therapy targeting these conditions. 

What is Crohn’s disease?

Crohn’s disease is a type of IBD where there’s inflammation of the entire GI tract, or parts of it, from mouth to anus. In addition, the entire thickness of the bowel wall is involved in Crohn’s disease, which can lead to some serious complications.

Symptoms of Crohn’s disease

The symptoms of Crohn’s disease depend on which parts of the GI tract are involved. Common symptoms include abdominal pain, weight loss, and diarrhea.

If Crohn’s affects the lower part of the GI tract, such as the colon and the small intestine, you might also experience:

• Abdominal pain

• Diarrhea

• Bloody stool

If Crohn’s affects the upper part of the GI tract, such as the stomach, you might experience:

• Pain after eating

• Nausea and vomiting

• Bloating

There are also parts of the body that can show symptoms outside the GI tract. People with Crohn’s may experience:

• Skin rashes

• Eye pain and inflammation

• Joint pain

• Fatigue

Complications of Crohn’s disease

Crohn’s disease can lead to some serious complications, such as:

• Fistulas (a hole formed between the intestines and other body parts such as the skin, bladder, or vagina)

• Abscesses (pockets of infection)

• Strictures (a narrowing of the bowel that can lead to blockages)

• Cancers of the GI tract

What is ulcerative colitis?

Ulcerative colitis is another type of IBD. It’s also an autoimmune disorder. Unlike Crohn’s disease, ulcerative colitis only involves the colon or large intestines. It only affects the inner lining of the colon, instead of the whole wall thickness.

Symptoms of ulcerative colitis

Symptoms of ulcerative colitis include:

• Diarrhea with blood or mucous 

• Abdominal pain or cramping

• Sensation of incomplete emptying with bowel movements

• Urgency to pass stool

• Fatigue

• Weight loss

And there can be symptoms outside of the GI tract, like:

• Skin rashes

• Eye pain and inflammation

• Joint pain

• Fatigue

Complications of ulcerative colitis

Ulcerative colitis can also lead to some serious complications, such as:

• Severe bleeding

• Rupture of the colon

• Colon cancer

These complications may need surgery to treat them.

What’s the difference between ulcerative colitis and Crohn’s disease?

Ulcerative colitis and Crohn’s disease are both types of inflammatory bowel disease (IBD). IBD is an autoimmune disorder, meaning the immune system that usually fights off infections is mistakenly attacking your own body. 

While they’re similar, there are some differences between ulcerative colitis and Crohn’s disease. 

These differences include:

• Areas of the GI tract affected

• Potential complications

• Treatments

Let’s take a closer look at each condition to see the similarities and differences.

How can you tell if you have ulcerative colitis or Crohn’s disease?

To figure out what’s causing your symptoms, work together closely with your primary care provider and a GI specialist. This is especially important since the symptoms of Crohn’s disease and ulcerative colitis can be similar. 

To get an accurate diagnosis, your GI specialist may do a colonoscopy, where they put a camera into the colon. They will look at the inside of the colon and take tissue samples. 

Your healthcare team might get a CT scan or an MRI of your abdomen to check for complications related to your condition.

How is treatment of Crohn’s disease different from ulcerative colitis?

Although both Crohn’s and ulcerative colitis are both forms of IBD, some medications work better for each condition. For example, if you have ulcerative colitis, aminosalicylates are commonly prescribed. But only a limited number of people with Crohn’s disease will benefit from these medications. 

When it comes to more advanced therapies like biologic agents, some can only be used for ulcerative colitis and some can only be used for Crohn’s disease.

Keep in mind that many medication classes treat both conditions, so there’s a lot of overlap. 

Frequently asked questions

Why trust our experts?

Written by:

Michael Dreis, MD

Dr. Dreis is an emergency medicine physician currently practicing in Milwaukee, Wisconsin. He went to medical school at the University of Wisconsin – Madison and completed his residency at Henry Ford Hospital in Detroit, Michigan.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

Our editorial standards

Meet our experts