IBS, Crohn’s or Colitis? The Difference Between IBS and Crohn’s, Explained
If your belly swells by late afternoon until you look nine months pregnant, or meals send you running for the bathroom, you’re not imagining it, and you’re not alone. As a Doctor of Traditional Chinese Medicine, I want to offer you a different way of seeing your gut. In Part 1 we’ll look at what’s actually going on, starting with the difference between IBS and Crohn’s disease, and why stress hits your gut so hard. In Part 2 we’ll get practical about food and daily habits.
This topic is personal for me. In my last year of university I was diagnosed with Crohn’s disease, and I ended up having a foot of my small intestine removed. I know what it’s like when food becomes a landmine.
IBS, Crohn’s and colitis: what’s the difference?
These three get mixed up all the time, but they’re very different conditions.
| IBS | Crohn’s disease | Ulcerative colitis | |
|---|---|---|---|
| What it is | A functional disorder: the bowel works poorly, but there’s no damage | Autoimmune inflammation | Autoimmune inflammation |
| Where | The bowel, with no visible damage | Anywhere from mouth to anus, in patches with healthy sections between; most often the end of the small intestine (ileum) | Colon and rectum only, starting in the rectum and spreading upward in one continuous stretch |
| Typical symptoms | Cramping, bloating, diarrhea or constipation | Lower-right pain after eating, night-time diarrhea, night sweats, weight loss, fatigue, anemia | Bloody diarrhea, urgency, cramping, feeling you still need to go, fever, weight loss |
| Blood in stool | No | Sometimes | Often |
| How it’s diagnosed | From symptoms, once other causes are ruled out | Colonoscopy or endoscopy, blood and stool tests | Colonoscopy, blood and stool tests |
The tests your doctor may order for Crohn’s or colitis include C-reactive protein and the sed rate (ESR), which measure inflammation, a complete blood count to check for anemia, and fecal calprotectin. That’s a stool test for inflammation in the bowel, and it’s the main test used to tell inflammatory bowel disease apart from IBS.
If you have Crohn’s or colitis, Traditional Chinese Medicine can support you, but it works alongside your GI specialist, not instead of them.
Please don’t ignore these signs
If you have blood in your stool, don’t just ask for a colonoscopy, advocate for one. Fresh blood is often put down to hemorrhoids, and hopefully that’s all it is. But if you’ve had gut problems for a long time, push to rule out colon cancer.
See your doctor promptly if you have:
- Blood in your stool
- Weight loss you can’t explain
- Symptoms that wake you up at night
- Anemia or ongoing fatigue
- A family history of colon cancer, Crohn’s or colitis
- New bowel changes after age 50
Colon cancer is rising in people under 50. One of my patients, a woman of 31, had her colon cancer missed because she was considered too young. She’s going to be okay, but her diagnosis and treatment have been life altering. Being too young is not a reason to skip the test.
Why IBS? The Chinese Medicine view
IBS is common. Canada has one of the highest rates in the world according to the GI Society of Canada 13-20% of Canadians (approximately 5 – 7.5 million individuals) are living with IBS.
It’s diagnosed more often in women. Western medicine points to hormones and the gut-brain axis. Traditional Chinese Medicine adds something: we tend to hold our emotions in our gut.
Try this. Press gently just below your breastbone, into the soft spot where your ribs meet. If it’s tender, from a TCM perspective you’re holding a lot of stress and tension there. (If the pain is sharp or doesn’t go away, have it checked, since gastritis and ulcers show up there too.)
Qi: energy that has to move
TCM is energy medicine. Qi simply means energy. The organ that keeps qi flowing smoothly through the body is the liver. When we’re happy and healthy, eating well and moving, our qi flows freely.
Now think of a time you had a lump in your throat. Your emotions were so big you could hardly swallow. That’s qi getting stuck. TCM even has a name for it, plum-pit qi. An MRI would show nothing there, yet the feeling is completely real.
When the liver overacts
Imagine carrying a lot of emotion, and instead of getting stuck in your throat, it gets trapped in the liver. Picture a balloon getting bigger and bigger. Eventually it presses on its neighbours, the spleen and the stomach. In TCM we call this the liver overacting on the spleen.
Energy has to move, just like water. If you’ve ever had gut pain right below your ribs after a big argument, that’s liver qi stagnation: anger, resentment and frustration, held in the body as trapped energy.
Digestive qi: why worry goes straight to your gut
It takes energy to break down food. TCM calls this digestive qi, and it belongs to the spleen. Overthinking and worry weaken it. When digestive qi is too weak, food isn’t properly broken down, and it goes right through you.
That’s why the more you worry, the worse your IBS gets. It’s also why bloating is often worse later in the day: you’re more tired, and you have less energy left for digestion.
Emotions live in the body
In TCM, emotions are energy with a feeling attached, and each is linked to an organ:
- Anger: liver
- Joy: heart
- Sadness and grief: lungs
- Fear: kidneys
- Worry and overthinking: spleen and stomach
Unprocessed emotions take up a lot of storage in the body, and they use up energy. If you live with constant anxiety, I’d expect gut problems. In a state of fear, food isn’t being properly digested and absorbed.
Think about how you feel on holiday. You’re relaxed and happy, eating whatever you like, and your gut is fine. Then you get home, and everything is waiting for you: responsibilities, aging parents, kids who are struggling, money worries. All of that drains your energy, and your gut feels it.
If you have a trauma history, this connection runs deep, and it deserves more than a blog post. I’d encourage you to book a consultation.
Coming up in Part 2
So how do we help ourselves? In Part 2, I’ll share how to use food as medicine, from a morning ginger tea to why TCM loves rice, plus four simple steps to a calmer gut.
