Subscribe to the Magazine for free.
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.

IBS vs IBD: Know The Symptoms

IBS vs IBD: Know The Symptoms

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) may sound similar, but they are actually two very different health conditions with equally different treatment options. Together, they affect over 11% of the population - 0.8% of people experience IBD, while over 10% will experience IBS at some point in their lives.

But what exactly is the difference between IBS and IBS, and how can you tell for sure which one you have?

Knowing whether you have IBS or IBD can make all of the difference in how you recover from the gastrointestinal symptoms that are impacting your life.

This article will discuss the differences between IBS and IBD and how to use state-of-the-art testing to heal IBS and IBS using a functional medicine approach.

[signup]

What is IBS?

Irritable bowel syndrome, or IBS, is a diagnosis based on symptoms of gastrointestinal discomfort and altered gastrointestinal function. It’s typically characterized by regular abdominal discomfort associated with changes in bowel habits like constipation and diarrhea.

IBS is considered a Functional Gastrointestinal Disorder (FGID) or Functional Bowel Disorder (FBD) - a disorder characterized by alterations in gut function rather than observable changes to anatomy or lab values. This means that - with IBS - you may hear from your doctor, “Everything looks normal,” even when things don’t feel that way.

IBS is a common condition that affects over 11% of the world’s population. Less than 50% of people with IBS symptoms seek medical care for their issues in any given year, meaning many people are suffering from IBS in silence - without the help that could improve their symptoms.

IBS affects people in female bodies at approximately 1.5-3.0 times the rate that it affects people in male bodies and tends to affect people under the age of 50 more frequently than those older than 50. It accounts for half of all referrals to gastroenterologists.

Irritable bowel syndrome can cause significant financial and health issues that impact work, social life, and more. IBS costs workers roughly $205 million annually in the U.S. in lost wages, productivity, and sick days. IBS accounts for over 600,000 office and emergency room visits in the U.S. each year.

These statistics collectively mean that if we could heal IBS for more people, we’d save billions across the globe each year, put more money back into people’s pockets, reduce emergency room visits, and reduce the burden on gastroenterology practices by half. Thankfully, there’s emerging evidence that functional medicine approaches to IBS may be able to do just that.

IBS Signs & Symptoms

Irritable bowel syndrome often feels just like it sounds! People with IBS report that their guts feel irritable and bothered by small things that others tolerate just fine.

Many people notice that their IBS symptoms of abdominal discomfort, cramping, constipation, and diarrhea increase with stress.

To officially diagnose IBS, a physician must first have ruled out other possible causes of GI dysfunction. After that, a person’s symptoms must fit the ROME IV criteria for IBS.

ROME IV criteria for IBS state that symptoms of abdominal pain have to have occurred for

  • at least one day per week
  • every week
  • for the past three months.

Additionally, the symptoms above must be characterized by at least 2 of the following symptoms:

  • Abdominal pain is related to defecation. In practice, this could mean that someone’s symptoms of abdominal pain get better after a bowel movement or get worse.
  • Abdominal pain is related to a change in stool frequency. This usually means pain is associated with increased or decreased stool transit time or GI motility. People with IBS report that their symptoms often occur in conjunction with a day or two of constipation, slow passage of food through their GI tract, or diarrhea (loose stool).
  • Abdominal pain is related to a change in the form or appearance of stool. This means stool can be more or less formed during pain flares - either turning hard and clumpy or loose and watery. The Bristol Stool Chart can help classify changes in stool form.

3 Major Types of Irritable Bowel Syndrome

IBS-C

IBS-C stands for IBS - constipation subtype. People with this type of IBS experience constipation frequently and rarely experience diarrhea.

IBS-D

IBS-D stands for IBS - diarrhea subtype. People with this type of IBS experience diarrhea frequently and rarely experience constipation.

IBS-M

IBS-M stands for IBS - mixed subtype. People with this type of IBS experience both constipation and diarrhea.

IBS Possible Causes from Conventional Medicine Standpoint

Conventional medicine doesn't know yet what causes IBS, mainly because symptoms of IBS are variable in each person and may have different root causes.

What is known is that the incidence of IBS is higher in industrialized nations and that IBS is more likely in people under 50, females, and people with other conditions like fibromyalgia, chronic fatigue syndrome, depression, anxiety, and other gastrointestinal disorders like gastroesophageal reflux disease.

Common Reason's for IBS From a Functional Medicine Standpoint

A complex interplay of genetics, environment, microbiome, stress, nervous system function and inflammation may all play a role in the pathophysiology of IBS symptoms. Other reasons include the following:

Increased Immune Activity

People with IBS tend to have higher levels of lymphocytes, inflammatory cytokines, and interleukins in the lining of their GI tracts than people without IBS.

Mast Cells

People with IBS have more intact mast cells and degranulated mast cells in the tissues close to the nerve endings in the colon, which can stimulate the pain sensation. Mast cells release histamine, an excitatory neurotransmitter, which may play a role in the increased sensitivity to pain and distention that people with IBS experience.

Motor Activity

It's thought that impaired motor activity - whether due to microbiome dysfunction, nervous system, or musculoskeletal issues - may play a role in the pathophysiology of IBS.

GI Infections

It's well-known that people can develop IBS after an episode of gastroenteritis.

Microbiome Alterations

Multiple studies have established that people with IBS have significantly different microbiome profiles than people without IBS. Studies have found that people with IBS-C have increased severity of constipation, corresponding to increased levels of methane production in their GI tracts, a hallmark sign of small intestinal bacterial overgrowth (SIBO) and intestinal methanogen overgrowth (IMO). On the other hand, IBS-D sufferers are ten times more likely to suffer from hydrogen-predominant SIBO.

Stress

People with IBS tend to react to stress differently than people without IBS. For example, stress hormones can trigger symptoms in the colonic tissue of people with IBS but do not trigger the same tissues in people without IBS. Additionally, people with IBS tend to produce more stress hormones like cortisol in reaction to stressors than people without IBS.

Food Sensitivity

When IBS sufferers avoid foods to which they are sensitive (as evidenced by having increased IgG and IgG4 antibodies to those foods), they can experience a 10-25% decrease in their symptoms, including pain, bloating, and dissatisfactory bowel movements.

Functional Medicine Labs to Test for IBS

The most important part of diagnosing IBS is first to do the workup required to ensure it's not anything else. IBS is known as a "diagnosis of exclusion"; this means the clinician who diagnoses someone with IBS must have performed testing to exclude the possibility that symptoms are being caused by a different disorder (like IBD, celiac disease, metabolic or nervous system issues, musculoskeletal issues and more).

Standard Tests to Rule Out Other GI Disorders Before Diagnosing IBS

  • Rule Out Celiac Disease: Symptoms of celiac disease can mimic those of IBS, including altered bowel habits like diarrhea and stomach pain.
  • Rule Out IBD: It's important to rule out inflammatory bowel disease as part of the workup for IBS. Standard tests for IBD include fecal calprotectin, fecal lactoferrin, and serum CRP. These are covered more extensively in the Functional Medicine Testing for IBD section below.
  • FIT (fecal occult blood testing): can be used to screen for structural issues in the colon that cause bleeding, which is more typical of IBD than IBS. It can be run independently or as part of more comprehensive functional medicine tests like the GI Comprehensive Profile.
  • Infections: Standard care includes ruling out gastrointestinal infections if symptoms like diarrhea are present before diagnosing someone with IBS.

Tests to Find The Root Cause of IBS

There is no singular root cause of IBS. Because IBS is a disorder defined by symptoms and not pathology, there are several possible causes of gastrointestinal issues that present with IBS, as mentioned above. These tests include:

  • Complete Blood Count: It's recommended to order a complete blood count, or CBC, before diagnosing someone with IBS.
  • Comprehensive Stool Profiles: Stool profiles can detect several possible contributing factors to IBS, including enzyme insufficiency, microbial overgrowth, SIBO, IMO, and pancreatic enzyme and hydrochloric acid deficiencies.  
  • SIBO Testing: can determine if methane or hydrogen dominance is a factor.
  • Food Sensitivities: testing can help determine if a patient reacts to a specific food, which could worsen IBS symptoms.
  • Salivary Cortisol: Measuring cortisol levels throughout the day can help detect abnormal responses to stress that may affect IBS symptoms.

Functional Medicine Treatment for IBS

This topic is covered extensively in an additional RUPA article, "A Functional Medicine Approach to IBS." Below are the common interventions prescribed by functional medicine practitioners for patients with IBS based on the patient's intake questionnaire and lab results.

What is IBD

Inflammatory Bowel Disease (IBD) is a condition characterized by chronic inflammation of the GI tract. IBD affects nearly 7 million people across the globe each year. In 2015, inflammatory bowel diseases accounted for over 7 billion dollars in healthcare expenditures in the U.S. alone.

IBD causes abdominal pain, altered bowel habits, and more severe symptoms than IBS. It can cause significant life impairment and increases the risk of other extra-gastrointestinal disorders if left untreated.

Inflammatory bowel diseases are categorized into two major disorders: Crohn's Disease (CD) and Ulcerative Colitis (UC).

Crohn's Disease

Crohn's can affect any part of the GI tract, from the mouth to the stomach to the intestines to the anus. The inflammation in Crohn's generally affects all layers of gastrointestinal tissue. Lesions (areas of damage) in the GI tract in Crohn's are not continuous - there are areas between each lesion that appear normal. This is why the characteristic lesions in Crohn's Disease are called "skip lesions."

Ulcerative Colitis

Ulcerative colitis (UC) typically affects the colon and rectum and generally affects areas in one continuous line as opposed to the skip lesions that are characteristic of Crohn's. People with UC typically have more bleeding and mucus associated with bowel movements because their distal colons and rectums are more affected than those with Crohn's.

IBD Signs & Symptoms

Both types of IBD (Crohn's and Ulcerative Colitis) involve abdominal pain, changes in stool, and systemic symptoms like fatigue. Unlike IBS, people can also experience symptoms in other parts of their bodies due to the high levels of inflammation that characterize IBD flare-ups, including

  • Weight loss
  • Fever
  • Dry, inflamed eyes
  • Joint issues and arthritis
  • Skin issues
  • Anemia
  • Abdominal tenderness and pain
  • Mouth ulcers
  • Nutrient deficiencies like anemia and more
  • Nausea
  • Vomiting
  • Anemia
  • Fistulas
  • Gangrene
  • Anal fissures

Rating scales like the Crohn's Disease Activity Index and Harvey-Bradshaw Index can be used to assess the severity of Crohn's disease to determine the need for therapeutic interventions.

Rating scales like the Montreal Classification can help organize UC symptoms for easy tracking and monitoring over time.

In clinical practice, assessing whether or not a client's symptoms and lab results are severe and debilitating generally determines the level of intervention. Monitoring the disorder requires a multi-pronged, holistic approach.

IBD Possible Causes

In general, inflammatory bowel disorders are thought to be triggered by several factors. These include

  • Infections
  • Inflammation
  • Oxidative stress
  • Genetics
  • Food allergy
  • Autoimmunity
  • Smoking
  • Sedentary lifestyle

Functional Medicine Labs to Test for IBD

Tests to diagnose and monitor the status of IBD fall into several categories.

Inflammation

Monitoring inflammation in IBD can help determine the severity of the disease activity and necessary interventions. Tests for monitoring inflammation in IBD include:

  • Fecal or serum calprotectin
  • Fecal lactoferrin
  • Serum C-reactive protein (CRP), an acute phase reactant that is often elevated with inflammation associated with IBD

Imaging

Imaging is essential for monitoring IBD's impact on the tissues in the rectum and colon.

  • Colonoscopy, CT, and MRI can give an inside view of the tissues of the lower GI tract.
  • Ultrasound can help to assess inflammation and damage to structures.
  • An abdominal x-ray can help to assess constipation or extreme changes to GI tract anatomy.
  • Anoscope can be used to view the anus and rectum.

Antibodies

ANCA and ASCA antibodies are often used to assess the disease state in IBD.

Fecal Elastase

People with IBD are more likely to have pancreatic enzyme insufficiency, which makes it difficult to digest foods.

Nutrient Deficiencies

The damage to the gastrointestinal tract in IBD makes nutrient deficiencies much more likely. The risk of the following nutrient deficiencies is increased in people with IBD.

Functional Medicine Treatment for IBD

Treatment for Crohn's and Colitis primarily focuses on optimizing nutrition, decreasing inflammation, and optimizing the microbiome.

Nutrition

Ensuring that people with IBD obtain adequate nutrients from their diets even during flares is an integral part of the medical management of these disorders due to the increased risk of nutrient deficiencies accompanying them.

Anti-inflammatory diets like mediterranean and plant-focused diets have been shown to improve symptoms of IBD.

Elimination Diet: there's evidence that people who avoid certain foods like dairy, wheat, and yeast can experience greater rates of remission of IBD symptoms long-term, even compared to standard therapy like steroids.

Herbs & Supplements

  • Herbs, including aloe, wheat grass, and curcumin, have been proven to improve symptoms of Ulcerative Colitis.
  • Boswellia serrata and Artemisia absinthium were both found to induce remission of symptoms in UC.
  • Butyrate is a short-chain fatty acid made by bacteria in the colon that provides fuel for the cells that line the lower GI tract. It can be taken orally or as an enema or colonic irrigation. Studies show that butyrate enemas can reduce symptoms of proctitis, a complication of IBD, more effectively than standard medications alone or a placebo.

Lifestyle changes

Lifestyle factors like smoking, a sedentary lifestyle, and obesity worsen outcomes in IBD, while regular exercise, yoga, meditation, and gut-directed hypnotherapy can improve IBD symptoms.

Summary

Being able to differentiate between IBS and IBD is a critical part of working up gastrointestinal issues to determine the root cause. By using a functional medicine approach to treating IBS and IBD, practitioners and people suffering from GI symptoms can develop a truly evidence-based, targeted functional medicine plan to heal their symptoms. The good news - whether you choose to use supplements, pharmaceuticals, nutrients, or lifestyle modifications, there are effective options to manage IBS and IBD symptoms and resolve them.

Lab Tests in This Article

Featured Bundles

No items found.

References

  1. IBS vs IBD. Crohn’s & Colitis Foundation. Published 2019. Accessed October 14, 2022. https://www.crohnscolitisfoundation.org/what-is-ibd/ibs-vs-ibd
  2. The. Understanding the Differences, Similarities of IBD and IBS | Children’s Hospital of Philadelphia. Chop.edu. Published February 16, 2021. Accessed October 14, 2022. https://www.chop.edu/news/understanding-differences-similarities-ibd-and-ibs
  3. IBS or IBD Symptoms: What is the Difference? | Cedars-Sinai. Cedars-sinai.org. Published 2018. Accessed October 14, 2022. https://www.cedars-sinai.org/blog/is-it-ibs-or-ibd.html
  4. IBS vs IBD. Bidmc.org. Published 2017. Accessed October 14, 2022. https://www.bidmc.org/about-bidmc/wellness-insights/gastrointestinal-gi-health/2016/04/ibs-vs-ibd#:~:text=IBS%20is%20a%20chronic%20syndrome,constipation%2C%20or%20alternating%20between%20both.
  5. Abdul Rani R, Raja Ali RA, Lee YY. Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place. Intestinal Research. 2016;14(4):297. doi:10.5217/ir.2016.14.4.297
  6. Probiotics for Gastrointestinal Disease. Uptodate.com. Published 2022. Accessed October 14, 2022. https://www.uptodate.com/contents/probiotics-for-gastrointestinal-diseases?search=ibs%20ibd&source=search_result&selectedTitle=8~150&usage_type=default&display_rank=8
  7. Medical management of low-risk adult patients with mild to moderate ulcerative colitis. Uptodate.com. Published 2022. Accessed October 14, 2022. https://www.uptodate.com/contents/medical-management-of-low-risk-adult-patients-with-mild-to-moderate-ulcerative-colitis?search=ibs%20ibd&source=search_result&selectedTitle=10~150&usage_type=default&display_rank=10
  8. Approach to functional gastrointestinal symptoms in adults with inflammatory bowel disease. Uptodate.com. Published 2022. Accessed October 14, 2022. https://www.uptodate.com/contents/approach-to-functional-gastrointestinal-symptoms-in-adults-with-inflammatory-bowel-disease?search=ibs%20ibd&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
  9. Approach to the adult with chronic diarrhea in resource-abundant settings. Uptodate.com. Published 2022. Accessed October 14, 2022. https://www.uptodate.com/contents/approach-to-the-adult-with-chronic-diarrhea-in-resource-abundant-settings?search=ibs%20ibd&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
  10. Clinical presentation and diagnosis of inflammatory bowel disease in children. Uptodate.com. Published 2022. Accessed October 14, 2022. https://www.uptodate.com/contents/clinical-presentation-and-diagnosis-of-inflammatory-bowel-disease-in-children?search=ibs%20ibd&source=search_result&selectedTitle=7~150&usage_type=default&display_rank=7
  11. Clinical manifestations, diagnosis, and prognosis of Crohn disease in adults. Uptodate.com. Published 2022. Accessed October 14, 2022. https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-crohn-disease-in-adults?search=ibs%20ibd&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5
  12. IBD vs. IBS. WebMD. Published April 22, 2016. Accessed October 14, 2022. https://www.webmd.com/ibs/guide/ibs-ibd-differences
  13. Pathophysiology of irritable bowel syndrome. Uptodate.com. Published 2022. Accessed October 14, 2022. https://www.uptodate.com/contents/pathophysiology-of-irritable-bowel-syndrome?search=ibs%20ibd&source=search_result&selectedTitle=16~150&usage_type=default&display_rank=16
  14. Clinical manifestations and diagnosis of irritable bowel syndrome in adults. Uptodate.com.Published 2022. Accessed October 15, 2022. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-irritable-bowel-syndrome-in-adults?search=ibs%20ibd&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3
  15. Sandler RS, Everhart JE, Donowitz M, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122(5):1500-1511. doi:10.1053/gast.2002.32978
  16. Peery AF, Crockett SD, Murphy CC, et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology. 2019;156(1):254-272.e11. doi:10.1053/j.gastro.2018.08.063
  17. Kaplan GG, Windsor JW. The four epidemiological stages in the global evolution of inflammatory bowel disease. Nature Reviews Gastroenterology & Hepatology. 2020;18(1):56-66. doi:10.1038/s41575-020-00360-x
  18. Mosli M, Alawadhi S, Hasan F, Abou Rached A, Sanai F, Danese S. Incidence, Prevalence, and Clinical Epidemiology of Inflammatory Bowel Disease in the Arab World: A Systematic Review and Meta-Analysis. Inflammatory Intestinal Diseases. 2021;6(3):123-131. doi:10.1159/000518003
  19. Alatab S, Sepanlou SG, Ikuta K, et al. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet Gastroenterology & Hepatology. 2020;5(1):17-30. doi:10.1016/s2468-1253(19)30333-4
  20. Kuenzig ME, Fung SG, Marderfeld L, et al. Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review. Gastroenterology. 2022;162(4):1147-1159.e4. doi:10.1053/j.gastro.2021.12.282
  21. Weight Loss, Fatigue, And Abdominal Pain Are Signs Of This Inflammatory Bowel Disease. Rupahealth.com. Published 2020. Accessed October 15, 2022. https://www.rupahealth.com/post/5-natural-treatment-options-for-ulcerative-colitis
  22. 4 Lifestyle Changes That Help Manage Crohn’s Disease. Rupahealth.com. Published 2020. Accessed October 15, 2022. https://www.rupahealth.com/post/a-functional-medicine-approach-to-crohns-disease
  23. A Functional Medicine Approach to IBS. Rupahealth.com. Published 2020. Accessed October 15, 2022. https://www.rupahealth.com/post/a-functional-medicine-approach-to-ibs-m
  24. How One Patient Found Relief for IBS. Rupahealth.com. Published 2020. Accessed October 15, 2022. https://www.rupahealth.com/post/a-functional-medicine-approach-to-ibs-m
  25. Card T, Canavan C, West J. The epidemiology of irritable bowel syndrome. Clinical Epidemiology. Published online February 2014:71. doi:10.2147/clep.s40245
  26. Kingsley M, Moshiree B. Irritable bowel syndrome. Clinical and Basic Neurogastroenterology and Motility. Published online 2020:421-434. doi:10.1016/b978-0-12-813037-7.00030-3
  27. Saps M, Nichols-Vinueza D, Dhroove G, Adams P, Chogle A. Assessment of Commonly Used Pediatric Stool Scales: A pilot study. Revista de Gastroenterología de México. 2013;78(3):151-158. doi:10.1016/j.rgmx.2013.04.001
  28. Lovell RM, Ford AC. Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-analysis. Clinical Gastroenterology and Hepatology. 2012;10(7):712-721.e4. doi:10.1016/j.cgh.2012.02.029
  29. Doshi JA, Cai Q, Buono JL, et al. Economic Burden of Irritable Bowel Syndrome with Constipation: A Retrospective Analysis of Health Care Costs in a Commercially Insured Population. Journal of Managed Care Pharmacy. 2014;20(4):382-390. doi:10.18553/jmcp.2014.20.4.382
  30. van Tilburg MA, Palsson OS, Levy RL, et al. Complementary and alternative medicine use and cost in functional bowel disorders: A six month prospective study in a large HMO. BMC Complementary and Alternative Medicine. 2008;8(1). doi:10.1186/1472-6882-8-46
  31. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional Bowel Disorders. Gastroenterology. 2006;130(5):1480-1491. doi:10.1053/j.gastro.2005.11.061
  32. Caio G, Volta U, Sapone A, et al. Celiac disease: a comprehensive current review. BMC Medicine. 2019;17(1). doi:10.1186/s12916-019-1380-z
  33. Hanevik K, Dizdar V, Langeland N, Hausken T. Development of functional gastrointestinal disorders after Giardia lambliainfection. BMC Gastroenterology. 2009;9(1). doi:10.1186/1471-230x-9-27
  34. Barbara G, Stanghellini V, De Giorgio R, et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology. 2004;126(3):693-702. doi:10.1053/j.gastro.2003.11.055
  35. Chadwick VS, Chen W, Shu D, et al. Activation of the mucosal immune system in irritable bowel syndrome. Gastroenterology. 2002;122(7):1778-1783. doi:10.1053/gast.2002.33579
  36. Caio G, Volta U, Sapone A, et al. Celiac disease: a comprehensive current review. BMC Medicine. 2019;17(1). doi:10.1186/s12916-019-1380-z
  37. Liebregts T, Adam B, Bredack C, et al. Immune Activation in Patients With Irritable Bowel Syndrome. Gastroenterology. 2007;132(3):913-920. doi:10.1053/j.gastro.2007.01.046
  38. Treatment of irritable bowel syndrome in adults. Uptodate.com. Published 2022. Accessed October 16, 2022. https://www.uptodate.com/contents/treatment-of-irritable-bowel-syndrome-in-adults?search=treatment%20ibs&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
  39. Kassinen A, Krogius-Kurikka L, Mäkivuokko H, et al. The Fecal Microbiota of Irritable Bowel Syndrome Patients Differs Significantly From That of Healthy Subjects. Gastroenterology. 2007;133(1):24-33. doi:10.1053/j.gastro.2007.04.005
  40. Malinen E, Rinttila T, Kajander K, et al. Analysis of the Fecal Microbiota of Irritable Bowel Syndrome Patients and Healthy Controls with Real-Time PCR. The American Journal of Gastroenterology. 2005;100(2):373-382. doi:10.1111/j.1572-0241.2005.40312.x
  41. Pimentel M, Lin HC, Enayati P, et al. Methane, a gas produced by enteric bacteria, slows intestinal transit and augments small intestinal contractile activity. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2006;290(6):G1089-G1095. doi:10.1152/ajpgi.00574.2004
  42. Chatterjee S, Park S, Low K, Kong Y, Pimentel M. The Degree of Breath Methane Production in IBS Correlates With the Severity of Constipation. The American Journal of Gastroenterology. 2007;102(4):837-841. doi:10.1111/j.1572-0241.2007.01072.x
  43. Atkinson W. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut. 2004;53(10):1459-1464. doi:10.1136/gut.2003.037697
  44. Zar S, Mincher L, Benson MJ, Kumar D. Food-specific IgG4 antibody-guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome. Scandinavian Journal of Gastroenterology. 2005;40(7):800-807. doi:10.1080/00365520510015593
  45. Fukudo S, Nomura T, Hongo M. Impact of corticotropin-releasing hormone on gastrointestinal motility and adrenocorticotropic hormone in normal controls and patients with irritable bowel syndrome. Gut. 1998;42(6):845-849. doi:10.1136/gut.42.6.845
  46. Böhn L, Störsrud S, Liljebo T, et al. Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome as Well as Traditional Dietary Advice: A Randomized Controlled Trial. Gastroenterology. 2015;149(6):1399-1407.e2. doi:10.1053/j.gastro.2015.07.054
  47. Chey WD, Hashash JG, Manning L, Chang L. AGA Clinical Practice Update on the Role of Diet in Irritable Bowel Syndrome: Expert Review. Gastroenterology. 2022;162(6):1737-1745.e5. doi:10.1053/j.gastro.2021.12.248
  48. Anti. Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Hepato-gastroenterology. 2022;45(21). Accessed October 17, 2022. https://pubmed.ncbi.nlm.nih.gov/9684123/
  49. Rao SSC, Brenner DM. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. American Journal of Gastroenterology. 2021;116(6):1156-1181. doi:10.14309/ajg.0000000000001222
  50. Camilleri M. Management Options for Irritable Bowel Syndrome. Mayo Clinic Proceedings. 2018;93(12):1858-1872. doi:10.1016/j.mayocp.2018.04.032
  51. Overview of Ulcerative Colitis. Crohn’s & Colitis Foundation. Published 2019. Accessed October 17, 2022. https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis/overview
  52. Rowe WA. Inflammatory Bowel Disease: Practice Essentials, Background, Pathophysiology. Medscape.com. Published June 14, 2021. Accessed October 17, 2022. https://emedicine.medscape.com/article/179037-overview
  53. Overview of the management of Crohn disease in children and adolescents. Uptodate.com. Published 2022. Accessed October 19, 2022. https://www.uptodate.com/contents/overview-of-the-management-of-crohn-disease-in-children-and-adolescents?search=ibd&source=search_result&selectedTitle=9~150&usage_type=default&display_rank=9
  54. Riordan AM, Hunter JO, Crampton JR, et al. Treatment of active Crohn’s disease by exclusion diet: East Anglian Multicentre Controlled Trial. The Lancet. 1993;342(8880):1131-1134. doi:10.1016/0140-6736(93)92121-9
  55. Nutrient and dietary management for adults with inflammatory bowel disease. Uptodate.com. Published 2022. Accessed October 19, 2022. https://www.uptodate.com/contents/nutrition-and-dietary-management-for-adults-with-inflammatory-bowel-disease?search=ibd&topicRef=4069&source=see_link
  56. Nutrition and dietary management for adults with inflammatory bowel disease. Uptodate.com. Published 2022. Accessed October 20, 2022. https://www.uptodate.com/contents/nutrition-and-dietary-management-for-adults-with-inflammatory-bowel-disease?search=ibd&topicRef=4069&source=see_link
  57. Overview of the medical management of mild (low risk) Crohn disease in adults. Uptodate.com. Published 2022. Accessed October 20, 2022. https://www.uptodate.com/contents/overview-of-the-medical-management-of-mild-low-risk-crohn-disease-in-adults?search=ibd&source=search_result&selectedTitle=10~150&usage_type=default&display_rank=10
  58. Aucoin M, Lalonde-Parsi MJ, Cooley K. Mindfulness-Based Therapies in the Treatment of Functional Gastrointestinal Disorders: A Meta-Analysis. Evidence-Based Complementary and Alternative Medicine. 2014;2014:1-11. doi:10.1155/2014/140724
  59. Zheng H, Chen R, Zhao X, et al. Comparison between the Effects of Acupuncture Relative to Other Controls on Irritable Bowel Syndrome: A Meta-Analysis. Pain Research and Management. 2019;2019:1-13. doi:10.1155/2019/2871505
  60. Clinical manifestations, diagnosis, and prognosis of ulcerative colitis in adults. Uptodate.com. Published 2022. Accessed October 21, 2022. https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-ulcerative-colitis-in-adults?search=ulcerative%20colitis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
  61. Management of moderate to severe ulcerative colitis in adults. Uptodate.com. Published 2022. Accessed October 21, 2022. https://www.uptodate.com/contents/management-of-moderate-to-severe-ulcerative-colitis-in-adults?search=ulcerative%20colitis&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4
  62. Satsangi J. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55(6):749-753. doi:10.1136/gut.2005.082909
  63. Harig JM, Soergel KH, Komorowski RA, Wood CM. Treatment of Diversion Colitis with Short-Chain-Fatty Acid Irrigation. New England Journal of Medicine. 1989;320(1):23-28. doi:10.1056/nejm198901053200105
  64. Wan P. Advances in treatment of ulcerative colitis with herbs: From bench to bedside. World Journal of Gastroenterology. 2014;20(39):14099. doi:10.3748/wjg.v20.i39.14099
  65. Rahimi R. Induction of clinical response and remission of inflammatory bowel disease by use of herbal medicines: A meta-analysis. World Journal of Gastroenterology. 2013;19(34):5738. doi:10.3748/wjg.v19.i34.5738
  66. Gupta M, Mishra V, Gulati M, et al. Natural compounds as safe therapeutic options for ulcerative colitis. Inflammopharmacology. 2022;30(2):397-434. doi:10.1007/s10787-022-00931-1
  67. Chiba M. Lifestyle-related disease in Crohn’s disease: Relapse prevention by a semi-vegetarian diet. World Journal of Gastroenterology. 2010;16(20):2484. doi:10.3748/wjg.v16.i20.2484
  68. Jiang Y, Jarr K, Layton C, et al. Therapeutic Implications of Diet in Inflammatory Bowel Disease and Related Immune-Mediated Inflammatory Diseases. Nutrients. 2021;13(3):890. doi:10.3390/nu13030890
  69. Jiang Y, Jarr K, Layton C, et al. Therapeutic Implications of Diet in Inflammatory Bowel Disease and Related Immune-Mediated Inflammatory Diseases. Nutrients. 2021;13(3):890. doi:10.3390/nu13030890
  70. Vernia P, Fracasso P, Casale V, et al. Topical butyrate for acute radiation proctitis: randomised, crossover trial. The Lancet. 2000;356(9237):1232-1235. doi:10.1016/s0140-6736(00)02787-2
  71. Rozich JJ, Holmer A, Singh S. Effect of Lifestyle Factors on Outcomes in Patients With Inflammatory Bowel Diseases. American Journal of Gastroenterology. 2020;115(6):832-840. doi:10.14309/ajg.0000000000000608
  72. Rozich JJ, Holmer A, Singh S. Effect of Lifestyle Factors on Outcomes in Patients With Inflammatory Bowel Diseases. American Journal of Gastroenterology. 2020;115(6):832-840. doi:10.14309/ajg.0000000000000608
Subscribe to the Magazine for free. to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.