Do I Have Crohn's Disease or IBS? A Quiz to Help Understand Your Symptoms

Updated by: Maya De La Rosa-Cohen

‍Irritable bowel syndrome (IBS) and Crohn's disease are two gut-related conditions that share some symptoms, including abdominal pain. Though it can be difficult to distinguish between the two, they are separate health conditions. 

Crohn's disease is an autoimmune disease that impacts the structure of the bowel and is one of two diseases categorized under inflammatory bowel disease (IBD). 

IBS is a functional gastrointestinal disorder marked by changes in the function of the GI tract.

Understanding the key differences between IBS and Crohn's disease can help you get the support you need.

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IBS vs Crohn's Disease

It can be hard to differentiate IBS from Crohn's disease, especially at the start of symptoms.

Both conditions can cause abdominal pain and significantly impact your quality of life. 

But there are several key differences between these two conditions, including how they impact the body.

Crohn's disease is a chronic disease related to autoimmunity that can cause inflammation and irritation to any part of the digestive tract.

IBS, on the other hand, doesn’t cause any signs of damage or disease to the digestive tract.   

Having IBS doesn't mean you'll develop Crohn's or vice versa—they are two separate conditions. Let's take a closer look at each in more detail.

What Is Crohn's Disease?

Crohn's disease is a chronic condition that causes inflammation along the GI tract, anywhere from the mouth to the anus.

The exact cause isn't known, but it’s believed to be a combination of genetics, immune dysfunction, and environmental exposures.

People with Crohn's may experience episodes of remission and relapse, with cases ranging from mild to severe.

Over time, inflammation in the bowel wall can lead to the development of fistulas, bowel obstructions, and strictures, some of which may eventually require surgery.

Is Crohn’s Disease the same as IBD?

Crohn’s disease is one type of inflammatory bowel disease (IBD).

‍IBD is a term used to describe two chronic conditions that affect the gastrointestinal tract: Crohn’s disease and ulcerative colitis.

Symptoms of Crohn's Disease

Symptoms of Crohn's disease can include:

• Abdominal pain, especially in the right lower belly.
• Weight loss.
• Diarrhea.
• Bleeding or mucus in stools.
• Fatigue.
• Gas and bloating.
• Anemia.

Crohn's disease can also cause extraintestinal symptoms which occur outside of the digestive system, including:

• Eye inflammation.
• Swelling and sores in the mouth.
• Arthritis, or painful, swollen joints. 

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Diagnosis and Treatment of Crohn's Disease

If you have symptoms of Crohn's, your doctor may recommend a comprehensive work-up, including blood tests, stool tests, endoscopy, and colonoscopy, to confirm and examine any structural changes or inflammation in the intestines. 

Fecal calprotectin, a test specifically used for IBD, and inflammatory markers like C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) are often used to differentiate between IBS and Crohn's and monitor disease activity.

‍Treatment for Crohn's depends on the severity and progression of the disease.

In many cases, treatment combines medications, including steroids or biologics, to suppress the immune system, with certain lifestyle changes, including diet. 

Diet is an essential part of supporting the health of the digestive tract and addressing inflammation in people with Crohn’s disease.

Certain foods or textures can trigger symptoms or irritate the lining of the intestines, especially during a flare-up. Undernutrition is also a concern for people with Crohn's. 

If you have received a diagnosis of Crohn’s disease, a registered dietitian can help you create a personalized meal plan and guide you on proper dieting to help improve your symptoms.

What is IBS?

Irritable bowel syndrome is considered a gut-brain disorder because the brain and nervous system can affect the health and function of the digestive tract.

Though typically not as severe as Crohn's disease, IBS can still cause considerable discomfort. It's also extremely common, affecting 5 to 10% of the population worldwide.

There are four categories of IBS, according to the American College of Gastroenterology (ACG):

• IBS-C: Constipation predominant.
• IBS-D: Diarrhea predominant.
• IBS-M: Alternating constipation and diarrhea.
• IBS-U: Meets the criteria for IBS, but stool consistency (loose or hard) doesn’t fall into the expected pattern of the above categories.

Women are more likely to be diagnosed with IBS. Prevalence also decreases with age, with 25% fewer people diagnosed after age 50. There's no single cause of IBS, but it’s likely related to factors including:

• History of physical or sexual abuse.
• History of mental health disorders, like anxiety or depression.
• Alterations in gut motility and the gut immune system. 
• Bacterial infections in the digestive tract.
• Food intolerances or sensitivities.
• Family history of the condition.

Symptoms of IBS

‍Symptoms of IBS vary from mild to severe and can include:

• Abdominal pain.
• Constipation, diarrhea, or both.
• Bloating and gas.
• Nausea.
• Changes in appetite.

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Diagnosis and Treatment of IBS

Diagnosis for IBS includes reviewing medical history and an exam to check for underlying conditions like IBD or celiac disease. 

The Rome IV criteria, a set of criteria that people with IBS must meet for diagnosis, state that people with IBS should report recurrent abdominal pain that occurs at least once a week in the last three months associated with at least 2 of the following:

• Pain related to bowel movements.
• Change in frequency of stool.
• Change in stool form (appearance) of stool.

Like Crohn's, treatment for IBS depends on severity.

Lifestyle changes addressing diet, sleep, and stress are often enough to manage IBS symptoms.

Medications may help with severe symptoms, but immunosuppressants aren't necessary. 

Diet can play a significant role in addressing and managing IBS.

Studies suggest that working with a registered dietitian to assess for gaps in nutrition and develop a supportive eating guide can significantly help with quality of life and lowering symptoms.

One of the most common patterns used for IBS is the low FODMAP diet.

FODMAP stands for fermentable oligo-, di-, mono-saccharides, and polyols, short-chain carbohydrates found in many foods.

Some people with IBS find these carbohydrates difficult to digest, causing gas, bloating, and other symptoms.

Importantly, the low FODMAP is not meant to be a long-term diet because it can be overly restrictive.

Working with a dietitian can help you customize the elimination and reintroduction phases to meet your needs.

8 Questions to Help Identify If You Have Crohn's Disease or IBS

The following questions can help you identify symptom patterns and guide a conversation with your doctor.

However, these results are only a starting point and not a replacement for medical advice.

Consider the following questions:

1. Have you experienced ongoing abdominal pain and discomfort at least once a week over the past three months?

Both Crohn’s disease and IBS can cause chronic abdominal pain and discomfort that disrupts your quality of life.

Though people with Crohn’s disease are more likely to experience pain in the lower right area of the abdomen, abdominal pain as a symptom on its own is not enough to distinguish between Crohn’s and IBS. 

2. Do you alternate between constipation and diarrhea?

IBS can cause both constipation and diarrhea.

Some people with IBS experience one or the other, but others can experience alternating episodes of constipation and diarrhea.

This condition is referred to as IBS-M. People with Crohn’s disease typically experience diarrhea but not constipation.   

3. Do your symptoms improve after having a bowel movement?

Gut-related symptoms, including abdominal pain, bloating, diarrhea, or constipation, that improve after having a bowel movement are more likely to be signs of IBS than of Crohn’s.

4. Do you experience anxiety or depression?

Anxiety and depression are believed to play a role in the development of IBS in some people.

If you have a history of anxiety or depression, it's possible that your gastrointestinal symptoms are signs of IBS.

5. Are you prone to developing mouth sores or ulcers? 

People with Crohn’s disease are prone to mouth sores and ulcers.

According to one review, an estimated 20–50% of people with Crohn’s disease will experience mouth sores.

Sores or ulcers can appear at any point during the disease’s progress.

For some people, mouth sores appear before they receive an official diagnosis for their symptoms.

In others, sores appear during flare-ups or as a side effect of medications used to treat the condition.

Sores and ulcers are also associated with nutritional deficiencies related to the disease.

6. Do you experience fatigue or weakness?

Feelings of fatigue, weakness, joint pain, or soreness can be symptoms of Crohn’s disease.

Some research suggests that stress can increase the severity of these symptoms.

7. Do you have unexpected weight loss?

Unexpected weight loss is also a symptom of Crohn’s disease. Crohn’s can cause intestinal bleeding, which makes it harder for the body to absorb the nutrients it needs to maintain weight.

The pain associated with Crohn’s disease can also lead to a decrease in food intake, which can cause weight loss.

8. Do you experience rectal bleeding or blood in your stools?

If you see blood in your stool or in the toilet bowl after a bowel movement, it’s important that you speak with your doctor as soon as possible.

Though it may be a sign of Crohn’s disease, there are conditions that can cause this symptom.

Interpreting Your Results

If you answered "yes" to questions one through four, consider speaking with your doctor about a possible IBS diagnosis. 

If you answered yes to questions numbered four through eight, reach out to a healthcare provider as soon as possible to discuss your symptoms.

Have IBS symptoms? Take the IBS quiz understand whether or not you have IBS.

Takeaway

IBS and Crohn's disease are two different conditions that affect the gut.

If you’re noticing any new or painful gut symptoms or changes in bowel habits, it’s important to speak with your healthcare provider.

And if you’re experiencing unexplained weight loss or blood in your stool, reach out to your doctor as soon as possible.

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How a Dietitian Can Help

A registered dietitian is an essential part of any digestive condition care team.

Diet can significantly impact symptom management, helping you feel better and get your life back.

‍Connect with an RD today.

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