- [voiceover] let meintroduce you to frank. now, for most of the last year, frank's digestive system, it's just not been feeling quite right. he's been having intermittent, although fairly frequent abdominal pain as well as irregular bowel movements. and at times he's not ableto have a bowel movement. then at other times he's beenhaving them very frequently.
and he was telling a closefriend about these symptoms. and his friend said, you know, frank, i was watching something on tv, and i heard about this condition. i'm not exactly sure,but i think it was called something like irritable bowel disease. and it sounds somewhat similarto what you're experiencing. perhaps you should go see a doctor. so frank goes to see his doctor.
and he says, you know,doc, i think i have ibd. and frank's doctor says, youknow, i'm sorry to hear that. please tell me why youthink you may have ibd. and as he's relatingthese symptoms to her, she thinks to herself, youknow, i wonder if he means ibs instead of ibd. and so his doctorresponds, frank, you know, i'm concerned you may have a condition known as irritable bowel syndrome,
which is commonly referred to as ibs. and frank says, isn't that ibd? and his doctor replies,that's a common mistake. unfortunately, there aretwo different conditions with very similar acronyms. they are irritable bowel syndrome or ibs and inflammatory bowel disease or ibd. let's learn about the differences between ibs and ibd.
so let's start on the left here with irritable bowel syndrome or as it's more commonly referred to, ibs. but what exactly is a syndrome? to help get a better idea,let's think about a car. now, imagine that something is just not quite right with your car. so you take it into the auto shop. and you tell the mechanic, you know,
there's this rattlingsound under the hood. and the car has poor acceleration, and the check engine light is on. so the mechanic says, youknow, it sounds like it may be car engine rattling syndrome. and that can be causedby many different things. it could be a loose part in the engine, a loose fan belt, or perhaps even low oil. now, car engine rattlingsyndrome may not be a real thing,
but it demonstrates theidea that a syndrome is not defined by the underlyingcause of the problems. there's multiple differentcauses for this one syndrome, but instead by the sounds and effects that it has on the car. similarly in medicine,syndromes are conditions that are defined by a set ofclinical signs and symptoms and not necessarily by their underlying pathologic mechanisms.
in fact, most syndromes can be caused by multiple different mechanisms that end up having the same presentation. so irritable bowel syndrome is a condition that's defined by a specificset of signs and symptoms, which we will discuss in just a moment. now, this is different from inflammatory bowel disease or ibd. so inflammatory boweldisease is not a syndrome.
it is a group of two disorders that occur due to a known mechanism,specifically inflammation. and these disorders are crohn's disease and ulcerative colitis. so what are the differencesbetween the two? well, for irritable bowel syndrome, the diagnosis is made clinically based on the frequencyand duration of symptoms, specifically recurrentabdominal pain or discomfort
at least three days per month for at least three of the last six months plus two or more of the following, pain that is improvedwith the bowel movement or the onset of pain is associated with the change in bowelmovement frequency, such as constipation or diarrhea. and lastly, the onset ofthe pain is associated with a change in the form of the stool.
so these are the symptomsfrank was experiencing. now, the cause or pathologicmechanism of ibs is unknown. and this is part of the reason why it's classified as a syndrome. now, similar to ibs, the exact cause of inflammatory bowel diseaseis not well understood. however, the underlyingpathologic mechanisms that result in crohn'sdisease and ulcerative colitis are known and can be identified.
so in both of these diseases there is an inappropriate inflammatory response. and this occurs within different portions of the digestive tract. and it results inidentifiable and observable pathologic intestinal damage. and it's these pathologicchanges that are necessary to make the diagnosis ofinflammatory bowel disease. now, for ulcerative colitis,the damage is contained
within the large intestine, whereas with crohn'sdisease the damage can occur anywhere throughout the gi tract, really. it can occur anywherefrom the mouth to anus. let's briefly discusssome of the differences between irritable bowel syndrome and inflammatory bowel diseasein regards to treatment. and we're gonna break thesetreatments into two groups, which we'll call symptomfocused and mechanism focused.
since both the irritable bowel syndrome and inflammatory boweldisease have similar symptoms, many of the symptoms focused treatments will be beneficial for both conditions. and these include things like diet and lifestyle modifications, such as a high fiber diet androutine physical exercise, as well as medications that speed up or slow down the intestines.
and that depends on whichsymptoms are present. so if there's diarrhea, then you can use anti-diarrheal medications. and if there's constipation,then you can use laxatives. now, since the mechanismsin ibs and ibd differ, the mechanism focusedtreatments will also differ. so although the exact mechanism of ibs is not well understood, it can be thought ofas anxiety of the gut.
and therefore, it responds tosimilar therapies as anxiety, including cognitivebehavioral therapy or cbt and anti-anxietymedications, such as ssris. now, in regards to ibd,as its name suggests, inflammatory bowel disease is due to an inappropriate inflammatory response. therefore, medicationsthat decrease inflammation, known as anti-inflammatorymedications, such as steroids, and medications that changehow the immune system
and the inflammatory cellsact, known as immunomodulators, can be used to decrease andprevent the inflammation that ends up causinginflammatory bowel disease. so this has just been a brief overview of the difference betweenirritable bowel syndrome, a disease that's defined byits clinical presentation, and inflammatory bowel disease, which is defined by theunderlying pathologic mechanisms.
