Digestive disorders: misdiagnosis and symptom overlap in gastrointestinal conditions

Digestive Disorders: Inflammatory Bowel Disease and Irritable Bowel Syndrome
It is important to note that in some instances, the symptoms patient present could be tied to a myriad of disorders. This has in some quarters led to misdiagnoses. Both inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) present a number of similar symptoms. IBD includes a number of inflammatory conditions whereby sections of a person’s digestive system are attacked by his or her immune system. The said conditions are inclusive of ulcerative colitis and Crohn’s disease. IBS, on the other hand, “is a problem that affects the large intestine” (U.S. National Library of Medicine, 2018). In essence, the movement of food in the intestines is enhanced by the relaxation and contraction of the intestines. When the said contraction as well as relaxation does not follow the normal pattern, symptoms of IBS are likely to present.
In basic terms, the pathophysiology of both IBD and IBS differs one person to the other on the basis of a several factors including, but not limited to, age, gender, race/ethnicity, and lifestyle (Story, 2017). Some of the more common symptoms associated with IBD include cramping and pain in the abdomen, bloody stool, diarrhea, and bowel movements that happen to be rather urgent and frequent (Centers for Disease Control and Prevention - CDC, 2018). Other symptoms could include weight loss, decreased appetite, and constant fatigue. Similarly, diarrhea, abdominal pain, and cramping are present in IBS. Symptoms unique to IBS include constipation, presence of mucus in stool, and bloating. Also, IBS (unlike is the case with IBD), does not bring about inflammation. It is also important to note that as Story (2017) points out, like is the case with IBS, individuals suffering from IBD often experience periods of remission whereby they present no symptoms at all, and periods of active disease.
When it comes to treatment, both IBS and IBD have no known cure. However, several medications are often used to manage both diseases and thereby suppress their symptoms. Both IBS and IBD, however, have different treatment paths. When it comes to IBD, some of the medications used include “aminosalicylates, corticosteroids (such as prednisone), immunomodulators, and the newest class approved for IBD—the ‘biologics’ (CDC, 2018). In addition to diet management, IBS is also managed using drugs such as lubiprostone (Amitiza) and alosetron (Lotronex) (Barbara, Cremon, and Stanghellini, 2014).
As it has been pointed out elsewhere in this text, the pathophysiology of, as well as treatments for both IBD and IBS could be impacted upon by a wide range of patient factors. To begin with, it is important to note that in most instances most persons are diagnosed with IBD between ages 15 – 35 (Story, 2017). As the author further points out, those in middle adulthood tend to present higher rates of IBS. On the gender front, IBD has equal impact on both genders. This is unlike IBS which appears to affect more women than men (U.S. National Library of Medicine, 2018). IBD, however, tends to affect more Caucasians than any other ethnic or racial demographic. Next, according to Story (2017), a person is more likely to be affected by either IBD or IBS if he or she has first-degree relative suffering from the same. IBD also has a lifestyle link, whereby those most likely to develop Crohn’s disease are smokers. It is also important to note that persons suffering from IBS could also have IBD. In the final analysis, I am in agreement with this assertion of Barbara, Cremon, and Stanghellini (2014), who point out that “IBD and IBS remain separate conditions although there are some overlapping mechanisms.”





References
Barbara, G., Cremon, C. & Stanghellini, V. (2014). Inflammatory Bowel Disease and Irritable Bowel Syndrome: Similarities and Differences. Curr Opin Gastroenterol, 30(4), 352-8.
Centers for Disease Control and Prevention – CDC. (2018). What is Inflammatory Bowel Disease (IBD)? Retrieved from https://www.cdc.gov/ibd/what-is-IBD.htm
U.S. National Library of Medicine (2018). Irritable Bowel Syndrome. Retrieved from https://medlineplus.gov/irritablebowelsyndrome.html