Irritable bowel syndrome and ulcerative colitis are chronic conditions that affect the digestive tract. These conditions may have similar symptoms, but there are important differences in how they’re treated.

Irritable bowel syndrome (IBS) and ulcerative colitis are conditions that affect the gut and cause gastrointestinal symptoms, such as stomach cramping and abdominal pain. While their symptoms may be similar, their causes and treatments are different.

Because both conditions can greatly affect a person’s quality of life, a correct diagnosis is critical for appropriate symptom management. Keep reading to learn more about how these conditions are alike, how they differ, and what tests can help tell them apart.

Ulcerative colitis, like Crohn’s disease, falls under the umbrella of inflammatory bowel diseases (IBDs). Ulcerative colitis is characterized by chronic inflammation caused by immune system reactions to bacteria within the colon and other triggers. Symptoms of colitis may also affect other parts of the body outside the gut.

IBS is a functional gastrointestinal disorder. It’s a group of symptoms that causes recurring abdominal pain and bowel movement changes. Symptoms of IBS primarily affect the gut.

These conditions have different causes and potential long-term effects. As a result, they also have notably different treatments. While it’s technically possible to have both IBS and colitis, these two conditions aren’t connected.

Both IBS and IBD cause gastrointestinal symptoms, including abdominal pain, cramping, and diarrhea. Likewise, both conditions are chronic, which means they’re long lasting and don’t have a cure. Both IBS and IBD can be managed with appropriate treatment.

Other similarities:

  • both may be linked to genetics
  • both may start at any age
  • both may get progressively worse without treatment
  • both may result in psychological distress

The abbreviations — IBS and IBD — are also similar and may cause confusion. Experts explain, though, that having IBS isn’t a first step to developing IBD and vice versa.

Language matters

You’ll notice that the language used to share stats and other data points is pretty binary, especially with the use of the terms “male” and “female.”

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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IBS is a syndrome, while ulcerative colitis is a disease. This means that IBS is a group of symptoms, while colitis is a condition with an identifiable root cause.

While doctors don’t know exactly what causes either condition, one key difference is that colitis is linked to an immune system reaction that triggers inflammation in the gastrointestinal tract. IBS, on the other hand, isn’t linked to immune system changes.

There are also differences in the signs and symptoms:

Signs and symptomsUlcerative colitisIBS
Gastrointestinal • watery, bloody, or mucousy stools
• frequent bowel movements
• loss of appetite
• mucousy stools
fecal incontinence
• diarrhea
• flatulence
• nausea
Elsewhere in the body• weight loss
• fatigue
• arthritis
• ulcers in the mouth
• eye irritation
bone density issues
skin changes
• liver issues
urinary symptoms
• back pain

Other major differences include what triggers the symptoms, the average age of onset, and how each condition is treated.

Other differencesUlcerative colitis IBS
Age and sexmales and females, primarily ages 15–30 years (but may occur at any age)more often affects females, ages 15–65 years
Triggerstriggers are still under investigationtriggers include certain foods or stress
Complicationspotential long-term effects include permanent damage to the colon or colon cancerpermanent damage not associated with IBS
Treatment• medication to address inflammation and induce remission
• surgery sometimes necessary
• lifestyle and diet changes
• probiotics
• medication
• therapy for mental health

Yes, the symptoms of IBS and IBD can be similar and difficult to tell apart on the surface.

One of the biggest differences between the two conditions is that ulcerative colitis causes visible signs of damage to the digestive tract, whereas IBS doesn’t cause these visible signs. Imaging tests and other diagnostic tools can help with a correct diagnosis.

A doctor may use a colonoscope to look for inflammation that’s characteristic of colitis but isn’t with IBS. Stool samples, blood testing, and other tests may also help diagnose colitis.

There’s no specific test that’s used to diagnose IBS.

Instead, a doctor will record your symptoms and perform additional testing (stool samples, blood tests, imaging, etc.) to rule out other conditions, such as IBD or colon cancer.

When to seek immediate medical care

There are many more conditions that may cause similar gastrointestinal issues. Some of these conditions are relatively benign (such as a stomach bug), while others may be more concerning (such as colorectal cancer).

Seek emergency help, by calling 911 or local emergency services, if you experience:

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Make an appointment with a doctor If you experience gastrointestinal symptoms that concern you.

While some features of IBS and colitis are similar, they’re different conditions with different treatments. Correct diagnosis is important to getting the right treatment and — most importantly — preventing possible complications or permanent damage.