Ibs Ibd

Chronic abdominal pain, diarrhea and altered bowel habits can arise from either irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), but the clinical fork is objective inflammation. IBS is a disorder of gut-brain interaction: symptoms are real and may be severe, yet there is no demonstrable inflammatory or structural intestinal lesion. Crohn disease and ulcerative colitis produce immune-mediated tissue inflammation that can be demonstrated through biomarkers, endoscopy, histology and, when needed, imaging. The distinction changes the plan. A patient with a typical Rome IV symptom pattern and no warning signs can usually move toward focused IBS treatment rather than years of exclusionary testing. Rectal bleeding, nocturnal symptoms, weight loss, anemia, fever or progressive symptoms make that working diagnosis unsafe and require objective assessment. The sections that follow connect the symptom pattern to the investigation, treatment and escalation decision.