Crohn’s Disease vs. IBS: What’s the Difference?

Byscott

Updated May 18, 2025

How can you tell if it’s Crohn’s or just IBS?

Here’s the simplest way to think about it: Crohn’s disease is inflammation you can see, while IBS is discomfort you can feel—but doctors won’t see obvious damage during a colonoscopy.

Crohn’s is one type of Inflammatory Bowel Disease (IBD), and it causes real, physical changes in your GI tract. You might have ulcers, swelling, or even sections of bowel that get narrowed. IBS, on the other hand, doesn’t leave visible signs on scans or scopes. It’s diagnosed based on symptoms like bloating, abdominal pain, and changes in bowel habits (hello, alternating constipation and diarrhea).

Some key differences:

• Crohn’s can affect any part of your digestive tract—from your mouth to your anus. IBS sticks to the large intestine.
• Crohn’s often comes with weight loss, fatigue, and inflammation you can see in bloodwork. IBS usually doesn’t.
• Crohn’s can cause lasting damage if untreated. IBS is frustrating but not physically damaging.

Still, these conditions can look really similar in everyday life. Both might involve rushing to the bathroom, feeling bloated after eating, or being in pain more days than not.

What causes Crohn’s disease vs. IBS?

Let’s talk root causes. We’re still learning a lot about both, but here’s what researchers know so far:

• Crohn’s disease is believed to involve an overactive immune response. Your body mistakenly attacks parts of the digestive system, causing chronic inflammation. Genetics, your microbiome, and environmental triggers (like smoking) all play a role. According to the NIH, Crohn’s affects nearly 780,000 Americans.
• IBS is more of a mystery. It’s considered a “functional GI disorder,” which means the gut looks normal but doesn’t work quite right. Stress, hormone changes, certain foods, and past infections may all trigger symptoms. IBS affects 10–15% of adults in the U.S., per the American College of Gastroenterology.

Neither condition is caused by anything you “did wrong.” But they require different approaches when it comes to managing flares, diet, and medications.

Do Crohn’s and IBS get treated the same way?

Short answer: nope.

• Crohn’s disease often needs prescription meds, like immune-modulators or biologics, to reduce inflammation and prevent damage. In some cases, surgery is required to remove severely affected parts of the bowel.
• IBS, on the other hand, is usually managed with lifestyle changes, stress reduction, dietary tweaks (like low FODMAP), and sometimes meds that regulate gut motility or sensitivity.

Here’s where it gets tricky: it’s possible to have both conditions at the same time. And some people with IBS-like symptoms are eventually diagnosed with Crohn’s. That’s why it’s so important to talk to your doctor, get the right tests (like colonoscopy, blood work, and stool studies), and track your symptoms.

The Takeaway

If your gut’s been giving you grief, don’t brush it off as “just stress” or “a sensitive stomach.” While IBS and Crohn’s disease can look similar, they’re very different under the surface—and they deserve different treatment plans.

The earlier you get clarity, the better your chances of feeling like yourself again. Start paying attention to your symptoms, keep a food journal, and bring it all to your next doctor’s appointment. You know your body best. Trust that inner voice if something feels off.