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  • Writer's pictureTina Shiver

Understanding IBS and IBD

icon of a stomach discussion IBS IBD


What is the difference between IBS (Irritable Bowel Syndrome) and IBD (Irritable Bowel Disease)? Both can produce similar symptoms which include stomach pain, bloating and diarrhea or constipation. The important thing to remember is that IBS and IBD have different treatments.

IBD is a structural disease. A marker called calprotectin can often distinguish between IBS and IBD as it is an inflammatory marker and if it is elevated then there is a possibility that a person has IBD. Crohn’s disease and ulcerative colitis are considered inflammatory bowel diseases.

Symptoms that can occur include stomach pain, weight loss, fever, blood in the stool and loss of appetite. Medications and sometimes surgery are the traditional route and are sometimes needed. A functional medicine practitioner will look at bloodwork, stool test, and possibly a food sensitivity test to determine some of the imbalances that could be contributing to the symptoms and may help the practitioner get to the root cause of the disease.


In functional medicine, some of the pathogenesis of IBD are genetics, environmental factors, and gut microbiota dysbiosis. Some of the environmental triggers for IBD are infections, overuse of antibiotics, NSAIDs, stress, diet, and smoking.

When it comes to the western diet, also called the “SAD” diet which includes red meat, processed food, refined sugar and saturated fat, research has shown that this type of diet can contribute to dysbiosis in the microbiome which in turn will cause impaired permeability and will create loss of tolerance in the immune system.

There have been studies that have shown that animal fat, milk fat, iron, and emulsifiers can actually flare IBD. High-fat sugar diets can lead to dysbiosis and leaky gut which in turn can lead to both IBS and IBD. Studies have shown that a high-fat diet promotes dysbiosis so someone following a KETO diet needs to be very careful.

We know that IBS can produce similar symptoms like IBD, however, the major difference is that it is not a structural disease it is a functional disease. Both are chronic, and both affect the gut. We know that between 25 and 45 million Americans are affected by IBS. You go into the doctor with constipation or diarrhea or bloating and more than likely you will be diagnosed with IBS.

This can be discouraging because most of the time it is treated with medication or a “low fiber diet” or a diet that is not designed for a person’s individual needs and they end up worse off. It’s so important to work with a dietitian who understands functional medicine because they can help to uncover the root cause of what may be going on. Remember each case may have similar symptoms, however different treatment plans.


For IBD it’s important to cool the inflammation. It’s important to remove foods that are inflammatory for example gluten/wheat and nightshades which include tomatoes, eggplant, and peppers. Next re-inoculate with pro and prebiotics, follow by repair using anti-inflammatory herbs and rebalance.

The diet recommendation could be different depending on whether you have Crohn’s or Ulcerative colitis. For example, two patients have ulcerative colitis and the same symptoms however one patient removes gluten/wheat and dairy and the diarrhea decreases. The other patient takes high doses of probiotics and starts to have less diarrhea with following a lean protein, high soluble fiber, healthy fat meal plan.

IBS can be caused by leaky gut, SIBO, Candida, parasites, food allergies/sensitivities, and stress.

We always go back to the 4R’s:

  • Remove

  • Replace

  • Re-inoculate

  • Repair

Asking specific questions about a person’s lifestyle and diet habits is important so you can begin to understand what triggers could be causing the IBS symptoms. Keep in mind that you have to peel the onion to get to the root cause so it may take a while to see some improvement in your symptoms. Sometimes a plan has to change according to how the gut heals.

If you suspect you may have IBS or IBD, I encourage you to seek out an Integrative Functional Medicine Practitioner to help you customize an eating plan that works for you.

Until next time…eat healthily and move.


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