For example, while Crohn’s and UC can both cause diarrhea, bleeding, and abdominal pain, UC inflammation is limited to the colon’s (large intestine) lining, says Stephen J. Bickston, MD, the associate chief of gastroenterology at Virginia Commonwealth University (VCU) Health Medical Center in Richmond. “Bloody diarrhea is its most common presentation, and persistent bleeding from UC can cause anemia.”
Unlike UC, Crohn’s inflammation can affect any part of the digestive tract, from mouth to anus. It may reach deeper layers of the intestine, and can cause more varied symptoms than UC, says Dr. Bickston.
Because of symptom overlap between IBD and other gastrointestinal (GI) conditions, it can be difficult to tell which you have. But with the right diagnostic tests, your healthcare provider can pinpoint the source.
1. Irritable Bowel Syndrome (IBS)
“IBS is a diagnosis based on symptom patterns rather than discrete findings on imaging or pathology, but most of the symptoms that can be experienced with inflammatory bowel disease can also happen in IBS,” says Abby Lochmann-Bailkey, MD, a gastroenterologist with SSM Health in Madison, Wisconsin. But people with IBD can also have IBS, she says, which can make diagnosis tricky.
IBS symptoms include:
- Abdominal pain
- Constipation
- Diarrhea
- Bloating
- Gas pain
- Changes in bowel movement appearance
IBS almost never causes weight loss or bleeding, Bickston says. “It is also very unusual for the pain of IBS to awaken a person from sleep.”
Both IBS and IBD are lifelong conditions of the GI tract. But, unlike IBD, IBS does not involve the immune system or cause inflammation and symptoms in other parts of the body.
2. Celiac Disease
When you have celiac disease, you can experience a wide variety of symptoms that also occur in IBD, says Dr. Lochmann-Bailkey.
Symptoms of celiac disease include:
- Bloating
- Frequent diarrhea
- Constipation
- Excess gas
- Lactose intolerance
- Loose, greasy, foul-smelling bowel movements
- Abdominal pain
- Nausea and vomiting
“Celiac disease can be mistaken for IBD, especially as it often presents early in life and can cause anemia, weight loss, diarrhea, and vitamin deficiencies,” says Bickston. “This is a nuanced circumstance, as celiac disease is more common in people with IBD than the general public, so patients may have both.”
Celiac disease and IBD can both affect your body’s ability to absorb essential nutrients. But their causes differ: eating gluten triggers celiac’s immune response, whereas IBD triggers are more complex. Celiac causes damage to the lining of the small intestine, but IBD may damage other areas of the GI tract, too, as previously described.
3. Hemorrhoids
Common hemorrhoid symptoms include:
- Anal itching
- Tender lumps near your anus
- Pain in and around your anus that worsens with sitting
- Rectal bleeding
Symptoms like rectal bleeding can look similar to IBD, but your healthcare provider can help you figure out which you have.
“Hemorrhoids often present with intermittent rectal bleeding that might raise suspicion of ulcerative colitis, but it is rare for bleeding hemorrhoids to cause anemia,” says Bickston. “They are most likely to produce streaks or drops of red blood with normal-colored stool, rather than bloody diarrhea, as with [IBD].”
4. Infectious Diarrhea
Symptoms of infectious diarrhea can include:
- Fever
- Bloody stools
- Stools with mucous
- Severe abdominal pain
Bloody diarrhea and abdominal pain may cause your healthcare provider to suspect an IBD. “Infectious diarrhea can start abruptly and can include blood in stools, which is why it is important to test stools for infection,” says Lochmann-Bailkey.
5. Segmental Colitis Associated With Diverticulosis (SCAD)
Unlike diverticulitis, SCAD causes inflammation in the intestinal lining around those pouches, but not in the pouches themselves.
Symptoms of SCAD may include:
- Lower abdominal pain
- Chronic diarrhea
- Blood in your stool
SCAD can look similar to IBD in some imaging and other diagnostic tests, but isn’t mistaken for IBDs as often as other conditions, says Lochmann-Bailkey. Although they may share some symptoms, providers can quickly tell IBD apart from SCAD with other imaging tests or by using a scope to visualize the lining of the GI tract.
The Takeaway
- Several gastrointestinal conditions cause symptoms like abdominal pain and bloody diarrhea, which can sometimes be mistaken for an inflammatory bowel disease (IBD), including Crohn’s disease or ulcerative colitis.
- The most common conditions that mimic IBD include irritable bowel syndrome (IBS), celiac disease, hemorrhoids, infectious diarrhea, and segmental colitis associated with diverticulosis (SCAD).
- If you have any new gastrointestinal symptoms or a change in bowel habits, talk to your doctor, who can help confirm a diagnosis and create a treatment plan.
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