The Irritable Gut: IBS Vs Crohn's Diseas

The Irritable Gut: IBS vs Crohn’s Disease

Do you know the difference between IBS-C, IBS-D, and Crohn’s disease? Gastrointestinal diseases often are lumped together or commonly confused. While irritable bowel syndrome (IBS) and Crohn’s disease are similar, they have key differences that require individualized medical and nutritional management.

Irritable Bowel Syndrome: IBS-C & IBS-D

Irritable bowel syndrome (IBS) is a disorder that affects the large intestine and can result in abdominal cramping, gas, bloating, diarrhea, and constipation. There’s IBS-C, which is marked by constipation, and IBS-D, which is marked by diarrhea. Some people actually have both, with periods of constipation followed by diarrhea, called IBS-mixed.

There is no test to diagnose IBS. Your doctor will look at your overall medical history, signs and symptoms, and even imaging to diagnose.

Chronic Inflammatory Bowel Disease

Crohn’s disease is the angrier, scarier big brother to IBS. Crohn’s disease is the chronic inflammation of the digestive tract. Unlike IBS, Crohn’s disease has inflammatory markers that help obtain a diagnosis.

While Crohn’s disease is an inflammatory bowel disease, it is not IBS.

Chron’s vs IBS

The inflammation found with Crohn’s disease spreads deep into the tissues of the bowels, and can affect any part of your GI tract, not just your colon like IBS. The symptoms of Crohn’s and IBS are similar, but often Crohn’s disease patients report more severe, cramping pain compared to IBS patients.

Nutrition and Managing GI Distress

Nutrition plays a key role in managing these gastrointestinal diseases. Together with your doctor, a Registered Dietitian can work to make sure you meet your nutritional needs while managing the side effects of IBS and Crohn’s disease.

Blanket Statements

I get a lot of questions of which foods to avoid, but managing IBS and Crohn’s is so individualized! Avoid believing blanket statements like “avoid all leafy vegetables” or “avoid all dairy,” what bothers you may not bother someone else and vice versa.

Temporary Elimination Diets

Elimination diets can be helpful here, to pinpoint which foods actually cause you GI distress. Trying a temporary elimination diet like Whole30 or following a low FODMAP diet means stripping your diet to the basics and slowly adding in foods like gluten, dairy, and sugar alcohols to see which foods may aggravate your IBS or Crohn’s.

Elimination Diets Tip

EXPERT TIP: The key here is to remember this is not a permanent diet and should not be followed for more than 1-2 months maximum.

Keep a Food Diary

Another less restrictive approach is to keep a food diary. The idea is to write down everything you eat, or use an app to track, and keep notes of which foods make you feel off. After two weeks or so, look at your results — you may find a pattern!

RELATED: Who should follow a gluten-free diet? (Why going gluten-free isn’t a trendy choice)

What to Eat (or Not) During a Flare-Up

In general, during a flare you may want to follow a low fiber, low residue diet. This temporary diet means relying on foods like white bread, bananas, baked chicken, and mashed potatoes. Chicken noodle soup is a favorite among my IBS and Crohn’s patients during a flare. Limit your spices, caffeine, mint, alcohol, and chocolate during a flare as these items can further irritate your GI tract.

Caroline is a Clinical Registered Dietitian for MedStar Health and Hospital Systems in Baltimore, Maryland. She completed her Masters Degree in Dietetics from San Jose State University and moved back to Charm City to be with her fiancee. When she’s not providing medical nutrition therapy to her patients, Caroline enjoys cooking, waterfront walks and crab-anything (crab pizza is the best!).


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