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Inflammatory bowel disease vs irritable bowel syndrome | NCLEX-RN | Khan Academy


– [Voiceover] Let me
introduce 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 able
to have a bowel movement. Then at other times he’s been
having them very frequently. And he was telling a close
friend 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 similar
to 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, you
know, I’m sorry to hear that. Please tell me why you
think you may have IBD. And as he’s relating
these symptoms to her, she thinks to herself, you
know, I wonder if he means IBS instead of IBD. And so his doctor
responds, 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 are
two 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 rattling
sound under the hood. And the car has poor acceleration, and the check engine light is on. So the mechanic says, you
know, it sounds like it may be car engine rattling syndrome. And that can be caused
by many different things. It could be a loose part in the engine, a loose fan belt, or perhaps even low oil. Now, car engine rattling
syndrome may not be a real thing, but it demonstrates the
idea that a syndrome is not defined by the underlying
cause of the problems. There’s multiple different
causes 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 of
clinical 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 specific
set of signs and symptoms, which we will discuss in just a moment. Now, this is different from inflammatory bowel disease or IBD. So inflammatory bowel
disease 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 differences
between the two? Well, for irritable bowel syndrome, the diagnosis is made clinically based on the frequency
and duration of symptoms, specifically recurrent
abdominal 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 improved
with the bowel movement or the onset of pain is associated with the change in bowel
movement frequency, such as constipation or diarrhea. And lastly, the onset of
the pain is associated with a change in the form of the stool. So these are the symptoms
Frank was experiencing. Now, the cause or pathologic
mechanism 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 disease
is not well understood. However, the underlying
pathologic mechanisms that result in Crohn’s
disease 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 in
identifiable and observable pathologic intestinal damage. And it’s these pathologic
changes that are necessary to make the diagnosis of
inflammatory bowel disease. Now, for ulcerative colitis,
the damage is contained within the large intestine, whereas with Crohn’s
disease the damage can occur anywhere throughout the GI tract, really. It can occur anywhere
from the mouth to anus. Let’s briefly discuss
some of the differences between irritable bowel syndrome and inflammatory bowel disease
in regards to treatment. And we’re gonna break these
treatments into two groups, which we’ll call symptom
focused and mechanism focused. Since both the irritable bowel syndrome and inflammatory bowel
disease 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 and
routine physical exercise, as well as medications that speed up or slow down the intestines. And that depends on which
symptoms 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 mechanisms
in IBS and IBD differ, the mechanism focused
treatments will also differ. So although the exact mechanism of IBS is not well understood, it can be thought of
as anxiety of the gut. And therefore, it responds to
similar therapies as anxiety, including cognitive
behavioral therapy or CBT and anti-anxiety
medications, such as SSRIs. Now, in regards to IBD,
as its name suggests, inflammatory bowel disease is due to an inappropriate inflammatory response. Therefore, medications
that decrease inflammation, known as anti-inflammatory
medications, such as steroids, and medications that change
how the immune system and the inflammatory cells
act, known as immunomodulators, can be used to decrease and
prevent the inflammation that ends up causing
inflammatory bowel disease. So this has just been a brief overview of the difference between
irritable bowel syndrome, a disease that’s defined by
its clinical presentation, and inflammatory bowel disease, which is defined by the
underlying pathologic mechanisms.

12 thoughts on “Inflammatory bowel disease vs irritable bowel syndrome | NCLEX-RN | Khan Academy

  1. Great video! However, I believe the name of the video needs to be edited to IBS (Irritable bowel SYNDROME) vs IBD (Inflammatory bowel disease). Thanks 🙂

  2. Not certain about the points made but ,if anyone else is searching for
    ibs treatment natural
    try Mackorny Defeat IBS Blueprint ( search on google ) ? Ive heard some extraordinary things about it and my m8 got cool results with it.

  3. Hi my name us Rhonda Pickett I am currently staying in Jackdob, MS there us a girl named Nateea Hodges that followed me to Mississippi five months ago she gas been living on NY body her Dawn Body and Sheika Brown there us a black guy asdisstibg them that has conpmete access to my body and has tgen living inside NY body Bateea has lost get mind eirh me these past 7 months and do gas John they gave bilkuobs of little people that tgey ca

  4. that tgey keep putting on my in my body and thus bitch gonna feel me that I cab not gave a bowel movement while she us living there she us really making this hi e and they keep putting all these little people in my body and will not let me use the bathroom she gonna say not while I'm living there these four badtards gave lost their mind with me zi have this to the point of death and tgey sitting here playing with it

  5. I died the last time they tied me up the done bofy had to undo me and now they are doing it agsin

  6. One thing though…the video doesn't really explain the CLINICAL DIFFERENCE, between IBS and IBD..which is what I was looking for.

    You started with the clinical vignet describing an IBS case, and then go on to describe IBD by it's causes and pathophysiological findings….but you never described what the patient with IBD would present with…

    close to the end of the video you mention that the treatment is similar because the symptoms are similar….but you still didn't explain HOW the symptoms differ.

    Even when you gave the part in the vignet where the doctor hears the case and says that it is IBS..you should have added a part where the doctor explains why it is NOT IBD based on the CLINICAL PICTURE

  7. You can change your diet to avoid foods that cause the inflammation. Research tumeric/aloe vera and other natural "cures". Give up processed lunch meats and other foods that cause inflammation . You can help yourself without letting the doctors take pieces of your colon and put you on $2,000 a month drugs.

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