IBD-IBS Overlap: 5 Things to Know
Health ConditionsDigestive HealthIBD

5 Things to Know About the IBD-IBS Overlap

5 Things to Know About the IBD-IBS Overlap
Everyday Health
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Published on October 22, 2026
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If your inflammatory bowel disease (IBD) is well-managed but you’re still having symptoms, irritable bowel syndrome (IBS) could be to blame. The condition often occurs alongside IBD, affecting up to 1 in 3 people with Crohn’s disease or ulcerative colitis.

“Overlap between IBD and IBS is fairly common,” says Supriya Rao, MD, a gastroenterologist with Tufts Medicine in Lowell, Massachusetts. “In my practice, I’d estimate that it affects 20 percent to 30 percent of my patients.”

The good news is that it’s possible to get both conditions under control. Here’s how these two conditions are connected, how you can manage them, and how to tell IBS and IBD symptoms apart.

1. IBD and IBS Are Distinct Conditions

IBDs are chronic inflammatory conditions that occur because of changes in the immune system or because of genetics. Without treatment, the chronic inflammation can damage the lining of the gut and lead to serious complications.

IBS is a chronic gastrointestinal (GI) disorder that affects how the gut and the brain communicate. It can cause the muscles and nerves in the GI tract to malfunction, which can lead to abdominal cramping, discomfort, and digestive issues. These symptoms can be sporadic and tend to be brought on by specific triggers like certain foods, stress, or hormonal changes.

Unlike IBD, IBS doesn’t cause inflammation or the GI tract damage that can come with it.

 “When we do a colonoscopy [to check on IBD inflammation], everything looks normal, but they’re still having symptoms,” says Dr. Rao. These symptoms can be uncomfortable and frustrating, but they don’t harm your gut lining or increase your risk for GI-related complications.

2. IBD and IBS Can Have Similar Symptoms

IBS and IBD have different causes and impact the GI tract in different ways, but they can often feel similar. Both conditions can cause the following symptoms:

  • Abdominal pain and cramping
  • Gas and bloating
  • Diarrhea or constipation
  • Bowel urgency

Because of the symptom overlap, it can sometimes be tough to tell which one is actually causing your symptoms when you have both. But in most cases, there are a few key differences, says Rudy Rai, MD, the founder and clinical director of Gastro Center of Maryland in Columbia. “IBD involves actual inflammation and may cause things like [rectal] bleeding, weight loss, or anemia, which you wouldn't typically see with IBS,” he says.

Inflammation from IBD can also cause problems with other parts of your body outside of your GI tract. These can include skin rashes or sores, joint pain, and eye problems.

3. IBS Symptoms Can Occur Even When Your IBD Is in Remission

Problems like abdominal pain, bloating, and diarrhea or constipation can stick around even when someone with IBD has little to no active inflammation in their GI tract. Experts now refer to this entity as IBD with IBS-like symptoms.

Why this happens isn’t fully understood. It’s thought that, in some cases, IBS-like symptoms could be a leftover effect of inflammation caused by IBD.

 “Even after the inflammation [from an IBD flare] settles down, changes in gut sensitivity, motility, and the gut microbiome can stick around and cause IBS-like symptoms,” Dr. Rai says.

4. Both Conditions Are Manageable

Neither IBD nor IBS can be cured. But the right treatment can control your symptoms, and in the case of IBD, reduce your risk for long-term complications.

IBD is typically treated with medications to limit or eliminate the inflammation in your GI tract. The right meds don’t just help you feel better — they allow your gut lining to heal and can help keep your IBD from worsening over time.

Treating IBS can be more about avoiding triggers to control your symptoms. “There isn’t one silver bullet, but it’s possible to find relief,” says Rao.

You might need to steer clear of certain foods, like those containing FODMAPs — fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which can be irritating to those with IBS. Other IBS management tactics include regular exercise, healthy sleep, and stress management techniques. Your doctor may also prescribe behavioral therapy, biofeedback, or gut-directed hypnotherapy. Some people benefit from fiber supplements, medications to relax the muscles in their GI tract, antidepressants, or antidiarrheal or anti-constipation meds.

Always check with your gastroenterologist before adding an over-the-counter IBS medication or supplement to your routine.

5. Persistent GI Symptoms Deserve a Closer Look

When you have overlapping IBS, not every new GI symptom means that you’re headed for an IBD flare. But when symptoms do come up or change, it’s important to let your gastroenterologist know soon after. “Testing and a proper evaluation can help tell whether there's actual inflammation,” so it can be treated appropriately, says Rai.

If, on the other hand, it’s just your IBS acting up, you can avoid ramping up your IBD treatment unnecessarily.

 Knowing that you’re not heading toward a flare can give you significant peace of mind, too.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Ma C et al. Recommendations for the Evaluation and Management of Inflammatory Bowel Disease With Irritable Bowel Syndrome–Like Symptoms: A Joint Rome Foundation and International Organization for the Study of IBD (IOIBD) Consensus. Gastroenterology. September 2026.
  2. Inflammatory Bowel Disease: Symptoms and Causes. Mayo Clinic. August 21, 2026.
  3. Irritable Bowel Syndrome (IBS). Cleveland Clinic. November 16, 2023.
  4. Commonly Mistaken Conditions. Centers for Disease Control and Prevention. June 12, 2024.
  5. Understanding the Differences Between IBD and IBS. Cleveland Clinic. March 27, 2023.
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