IBS, IBD, GORD – What’s the difference?
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Summary: Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), and Gastro-Ooesophageal Reflux Disease (GORD) are prevalent gastrointestinal conditions with overlapping symptoms. Expert GP Dr Lau comments that they differ in underlying pathology, required investigations and first line therapy. IBS is a functional gastrointestinal disorder that affects bowel habits without triggering inflammation. IBD, which includes Crohn’s disease and ulcerative colitis, involves chronic inflammation and structural damage to the digestive tract. GORD is caused by acid reflux affecting the oesophagus. Recognising the differences among these disorders is vital for proper diagnosis and effective clinical management.
The digestive system plays a vital role in maintaining overall health, and when it malfunctions, it can profoundly disrupt everyday activities. Among the most discussed gastrointestinal disorders are Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), and Gastro-Ooesophageal Reflux Disease (GORD). Although they may exhibit similar symptoms, they are distinct conditions with different causes, diagnostic criteria, and treatments. Gaining a clear understanding of their differences is crucial for effective management and patient well-being.
Brief overview of digestive disorders
Digestive disorders affect the gastrointestinal (GI) tract – from mouth to anus – and the accessory organs (liver, gall-bladder, pancreas). These disorders can vary from mild, temporary issues like indigestion or constipation to more chronic illnesses such as irritable bowel syndrome (IBS), acid reflux, Crohn’s disease, or ulcerative colitis. Common symptoms include abdominal discomfort, bloating, gas, diarrhoea, constipation, or heartburn. Digestive disorders can hinder nutrient absorption and overall wellness, but many can be effectively managed through lifestyle modifications, medication, and medical intervention.
Also read: Heartburn, Acid Reflux, or GORD: What's the Difference?
What is IBS (irritable bowel syndrome)?
Irritable bowel syndrome (IBS) is a prevalent digestive disorder that affects the functionality of the gut, particularly the large intestine. A recent survey estimated an IBS prevalence of 3.5% in Australia and 4.1% globally. It leads to symptoms such as abdominal pain, bloating, gas, and variations in bowel habits, like diarrhoea, constipation, or alternating between both. IBS doesn't cause lasting harm to the intestines or result in severe illnesses, but it can considerably impact daily comfort and quality of life. While the precise cause remains unclear, IBS is frequently associated with gut sensitivity, stress, dietary habits, and fluctuations in gut bacteria. Managing symptoms typically involves making nutritional adjustments, practising stress management, and, in some cases, taking medication.
Causes of IBS
The precise cause of irritable bowel syndrome (IBS) remains largely unknown, but various factors are thought to contribute to its onset. These may include:
- Irregular contractions of the gut muscles can result in cramping, bloating, or changes in bowel habits. Individuals with IBS might also experience increased sensitivity in their digestive system, causing them to feel discomfort more acutely.
- Other potential contributing factors include imbalances in gut bacteria, previous gastrointestinal infections, and emotional factors. These may influence the communication between the brain and gut. According to Dr Lau, Post-infections changes (especially after Campylobacter or Salmonella), altered gut-brain signalling, dysbiosis and visceral hypersensitivity are leading hypotheses.
- Hormonal fluctuations, particularly in women, and certain dietary components may also exacerbate symptoms.
IBS typically arises from a combination of these physical and psychological factors rather than a single cause.
Read more: Common IBS symptoms in females
Common symptoms
Frequent symptoms of irritable bowel syndrome (IBS) include bloating, which leads to a sense of fullness or swelling in the abdominal area, and abdominal pain or cramping that often subsides after a bowel movement. Variations in bowel habits are also common, manifesting as diarrhoea, constipation, or alternating episodes of both. Some individuals may observe mucus in their stool or feel that bowel movements are incomplete. The severity of these symptoms can fluctuate and often become more prominent during periods of stress or after consuming specific foods.
Triggers and risk factors
Common symptoms
Frequent symptoms of irritable bowel syndrome (IBS) include bloating, which leads to a sense of fullness or swelling in the abdominal area, and abdominal pain or cramping that often subsides after a bowel movement. Variations in bowel habits are also common, manifesting as diarrhoea, constipation, or alternating episodes of both. Some individuals may observe mucus in their stool or feel that bowel movements are incomplete. The severity of these symptoms can fluctuate and often become more prominent during periods of stress or after consuming specific foods.Triggers and risk factors
Triggers and risk factors for irritable bowel syndrome (IBS) differ among individuals but frequently involve certain dietary items, stress, and hormonal changes. Common food triggers are high-fat or spicy foods, caffeine, dairy products, and artificial sweeteners. Stress and anxiety can exacerbate symptoms by influencing the communication between the gut and the brain. Hormonal fluctuations, particularly in women during their menstrual cycle, may also provoke flare-ups.
Risk factors for developing IBS include having:- A family history of the condition
- Experiencing past gastrointestinal infections
- Having mental health issues such as depression or anxiety.
- IBS typically emerges before the age of 50 and is more commonly diagnosed in women than in men.
Diagnosis and treatment options
IBS is diagnosed based on symptomatology and by excluding other conditions. Medical professionals may inquire about your medical history, conduct a physical examination, and utilise tests like blood work, stool analysis, or colonoscopy if necessary. There is no verified test for IBS, so diagnosis follows patterns of symptoms according to criteria such as the Rome IV guidelines which requires at least 1 day per week of abdominal pain for at least 3 months, with onset at least 6 months ago.
Management is centred on alleviating symptoms. This may involve:- Dietary modifications include increasing fibre intake or adhering to a low FODMAP diet.
- Medications or anti-diarrhoeal agents may manage bowel irregularities.
- Stress management techniques can also help mitigate symptoms.
Significant features such as rectal bleeding, anaemia, unintentional weight loss, and nocturnal symptoms warrant review by a specialist to consider a colonoscopy.
What is IBD (Inflammatory Bowel Disease)?
Inflammatory bowel disease (IBD) encompasses a group of chronic illnesses that lead to inflammation within the digestive system. The primary types are Crohn’s disease and ulcerative colitis. While Crohn’s can impact any segment of the gastrointestinal tract, ulcerative colitis primarily affects the colon and rectum. Research highlights that 179,420 Australians are living with IBD in 2025.Explanation of Crohn’s Disease and Ulcerative Colitis
Crohn’s disease and ulcerative colitis represent the two principal forms of inflammatory bowel disease (IBD), each affecting the digestive system distinctly.- Crohn’s disease can impact any area of the gastrointestinal tract, from the mouth to the anus, and usually presents in uneven patches. It mostly affects the small intestine and can cause inflammation that penetrates all layers of the intestinal wall. Symptoms might consist of abdominal pain, diarrhoea, fatigue, and loss of weight.
- In contrast, ulcerative colitis is restricted to the colon (large intestine) and rectum. It induces continuous inflammation and ulcers along the colon’s lining. Common symptoms include bloody diarrhoea, abdominal cramping, and an urgent need to use the restroom.
Symptoms (persistent diarrhoea, fatigue, blood in stool).
The intensity of inflammatory bowel disease (IBD) symptoms can fluctuate, but frequent, urgent diarrhoea is a hallmark sign. Fatigue frequently occurs due to the persistent immune response and nutrient depletion. Blood in the stool is a critical symptom, particularly in ulcerative colitis, and it may be visible or intermixed with bowel movements.
Additional symptoms may consist of abdominal pain or cramping, unintended weight loss, decreased appetite, and, in some cases, fever. In more severe scenarios, IBD might lead to joint pain, skin issues, and inflammation in other body areas. Symptoms typically cycle between flare-ups and periods of remission.
Causes and immune system involvement
The definitive cause of inflammatory bowel disease (IBD) remains largely unknown, but it is believed to stem from a mix of genetic, environmental, and immune system factors. A key element is the abnormal immune response. In cases of IBD, the immune system attacks healthy tissue within the digestive tract, resulting in chronic inflammation.
Genetic predisposition may heighten risk, as IBD tends to run in families. Environmental factors, such as certain diets, smoking, stress, or infections, can also trigger or intensify the condition in those with a genetic vulnerability. Unlike infections, IBD is not due to bacteria or viruses, yet the immune system reacts similarly as if facing an ongoing threat. This incessant immune activity damages the intestinal lining, leading to symptoms and potential complications.
Diagnosis and treatment approach
To diagnose inflammatory bowel disease (IBD), a combination of medical history, physical exams, lab tests, and imaging is employed. Doctors may request blood and stool tests to identify inflammation, anaemia, or infections. Colonoscopy or endoscopy is frequently used to examine the internal digestive tract and obtain tissue samples (biopsies) for verification. Imaging tests such as CT or MRI scans also evaluate the degree of inflammation and any complications.
Treatment primarily aims to diminish inflammation, alleviate symptoms, and prevent flare-ups. Medications may involve anti-inflammatory agents, immune suppressants, corticosteroids, and biologics. In certain instances, antibiotics or analgesics may be recommended. Modifications to diet and nutritional support can further assist in managing symptoms.
For severe cases or complications, surgery might be required to excise damaged portions of the intestine. Long-term management usually entails consistent monitoring and treatment adjustments to maintain remission and enhance quality of life. Review of iron/B12 monitoring is also important in long-term management.
What is GORD (Gastro-oesophageal Reflux Disease)?
Gastro-oesophageal reflux disease (GORD) is a long-term condition characterised by the frequent backflow of stomach acid into the oesophagus, the tube that connects your mouth to the stomach. This backward flow, known as reflux, irritates the oesophageal lining and results in symptoms such as heartburn, a burning feeling in the chest, acid regurgitation, and sometimes trouble swallowing.
GORD develops when the lower oesophageal sphincter (a muscle ring located at the end of the oesophagus) weakens or relaxes inappropriately, permitting acid to escape upward. Although occasional acid reflux is typical, GORD is diagnosed when symptoms occur more than twice weekly or hinder daily activities. If not addressed, GORD may lead to more serious issues such as oesophagitis or oesophageal narrowing.
Common symptoms
Frequent heartburn is a common symptom of GORD, manifesting as a burning sensation in the chest often after meals or during nighttime. Acid reflux is another significant symptom; this happens when stomach acid rises into the oesophagus, frequently resulting in a sour or bitter taste in the mouth.
Regurgitation is also prevalent, where partially digested food or liquid comes back up into the throat or mouth. Other potential symptoms include difficulty swallowing, the feeling of a lump in the throat, chronic cough, sore throat, or hoarseness, particularly in the morning. These symptoms can vary in intensity and may worsen when lying down or after consuming large meals.
Risk factors and dietary triggers
Gastro-oesophageal reflux disease (GORD) can be affected by various risk factors and food triggers that diminish the effectiveness of the lower oesophageal sphincter or elevate stomach acid levels. Common risk factors include excess weight, pregnancy, smoking habits, certain medications (such as NSAIDs or blood pressure treatments), and the presence of a hiatal hernia. These elements can increase abdominal pressure or relax the muscle that prevents stomach acid from flowing back up.
Common dietary triggers in some patients typically consist of spicy dishes, citrus fruits, tomatoes, chocolate, peppermint, greasy or fried foods, onions, and caffeinated beverages. Fizzy drinks and alcohol can also play a role in causing acid reflux. Eating large portions or consuming food late in the evening can exacerbate symptoms.
Addressing weight loss together with these other risk factors and steering clear of identified food triggers can greatly alleviate GORD symptoms and help avoid flare-ups.
Diagnosis and treatment (including medications and lifestyle changes)
Diagnosing GORD usually involves a physical examination, discussion of symptoms, and at times, additional tests. These can include an upper endoscopy to visualise the oesophagus, pH monitoring to assess acid levels, or oesophageal manometry to evaluate muscle function.
Treatment focuses on minimising acid reflux and preventing harm to the oesophagus. Doctors often suggest lifestyle modifications like eating smaller meals, avoiding lying down post-meal, raising the head while sleeping, and maintaining a healthy weight.
Our expert says that they may likely recommend an 8-week trial of a proton pump inhibitor before progressing to an endoscopy if clinically indicated.
When to consult an online GP
Consulting an online doctor for digestive health is advisable when you encounter frequent or ongoing symptoms such as heartburn, abdominal discomfort, bloating, alterations in bowel habits, or unexplained weight loss. If over-the-counter solutions do not alleviate the symptoms or interfere with your daily life, seeking professional advice is crucial. An online GP can evaluate your symptoms, suggest tests if necessary, prescribe medications, and assist in managing chronic conditions like GORD, IBS, or IBD. Telehealth provides a convenient, private way to obtain prompt medical advice without needing to visit a clinic physically.IBS vs IBD vs GORD: Key Differences
| Feature | IBS (Irritable Bowel Syndrome) | IBD (Inflammatory Bowel Disease) | GORD (Gastro-oesophageal Reflux Disease) |
|---|---|---|---|
| Nature | Functional bowel disorder | Chronic inflammatory condition | Digestive disorder involving acid reflux |
| Cause | Unknown; linked to stress, diet, gut sensitivity | Autoimmune reaction causing intestinal inflammation | Weak lower oesophageal sphincter, acid backflow |
| Main symptoms | Bloating, abdominal pain, diarrhoea/constipation | Persistent diarrhoea, fatigue, blood in stool | Heartburn, acid reflux, regurgitation |
| Affects | Primarily large intestine | Entire digestive tract (Crohn’s) or colon (Ulcerative Colitis) | Oesophagus |
| Treatment focus | Diet, stress management, symptom relief | Anti-inflammatories, immune suppressants, surgery | Acid reducers, lifestyle changes, surgery, weight loss |
| Diagnosis | Symptom-based, Rome IV criteria, exclude other causes | Colonoscopy, biopsy, imaging, blood and stool tests | Clinical history, trial of PPI, possible endoscopy |
| When to consult GP | Frequent bloating, abdominal discomfort, altered bowel habits | Persistent diarrhoea, blood in stool, weight loss | Ongoing heartburn, acid reflux, difficulty swallowing |
| Telehealth support | Symptom review, diet advice, medication, referrals | Supportive care, medication review, specialist referral | Medication scripts, lifestyle tips, GP consult, referrals |
How telehealth can help with digestive health
Telehealth serves as a valuable resource for managing digestive health by providing easy access to medical guidance, particularly for ongoing issues like IBS, GORD, or IBD. You can book a virtual GP consultation to assess your symptoms, propose dietary or lifestyle alterations, prescribe IBS medications, and even request lab tests or imaging if required. It saves time, minimises travel requirements, and aids in follow-up care or monitoring of chronic digestive concerns. It’s important to note that IBD requires in-person endoscopy and specialist input and telehealth can support but not replace this. For flare-ups or new symptoms, online telehealth services provide expert assistance from the comfort of home, facilitating consistent management of your digestive health. You may also get referred to a gastroenterologist for specialist care.Conclusion:
In summary, while IBS, IBD, and GORD have overlapping symptoms, they vary in origin, intensity, and treatment. Accurate diagnosis is essential for effective management of each disorder.FAQs
What is irritable bowel syndrome?
Irritable Bowel Syndrome (IBS) is a common digestive disorder that affects bowel function without causing structural harm. Common symptoms include abdominal pain, bloating, and changes in bowel movement, such as diarrhoea, constipation, or a combination of both. Stress, specific dietary choices, or gut sensitivity often trigger it. IBS is not dangerous, but it can significantly affect a person’s quality of life. Treatment typically involves stress management, nutritional adjustments, and symptom relief.What causes irritable bowel syndrome?
Causes of IBS include:- Stress and anxiety
- Disrupted signals between the brain and the gut
- Abnormal gut movements
- Food sensitivities
- Gut bacterial imbalance
- Severe stomach infection
- Hormonal changes
How to cure irritable bowel syndrome?
Irritable Bowel Syndrome is a chronic condition, but it can be managed with the right combination of treatments and lifestyle changes. Here’s how IBS can be managed:- Diet changes: Follow a low-FODMAP (Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols) diet and avoid eating large meals.
- Stress relief: practice relaxation techniques and consider therapy or counselling.
- Probiotics: May help balance gut bacteria
- Exercise: Regular exercise improves bowel function and reduces stress.
What is inflammatory bowel disease?
Inflammatory Bowel Disease (IBD) is a chronic condition marked by persistent inflammation and damage in the digestive tract. It mainly includes Crohn’s disease, which can impact any part of the digestive system, and ulcerative colitis, which affects only the colon and rectum. Common signs include stomach pain, diarrhoea, weight loss, fatigue, and blood in the stool. While the exact cause remains unclear, it is believed to result from a combination of immune system dysfunction, genetic predisposition, and environmental triggers. Unlike IBS, IBD leads to visible inflammation and requires clinical intervention, including medications, lifestyle adjustments, and sometimes surgery.Can inflammatory bowel disease be cured?
Inflammatory Bowel Disease (IBD) is a lifelong condition that cannot be cured, but it can be effectively managed. With the right treatment, including medication, lifestyle adjustments, and sometimes surgery, many people can achieve prolonged remission and enjoy a good quality of life. While IBD is a permanent condition, timely and consistent care can make symptoms better and help prevent serious problems.What is gastro-oesophageal reflux disease?
Gastro-Oesophageal Reflux Disease (GORD) is a digestive disorder where stomach acid repeatedly flows back into the oesophagus, leading to symptoms such as acid reflux, burning chest pain, and acidic regurgitation. It occurs when the lower oesophageal sphincter (a valve between the stomach and oesophagus) weakens or relaxes at inappropriate times. Common triggers include obesity, high-fat foods, tobacco use, and lying down after eating. While usually not serious, untreated GORD can lead to complications like oesophageal irritation or tissue injury. Treatment includes lifestyle changes, acid-reducing medications, and in some cases, surgery.How to prevent gastro-oesophageal reflux disease?
Ways to prevent GORD include:- Eating smaller meals
- Avoiding trigger foods
- Maintaining a healthy weight
- Quitting smoking
- Limiting alcohol
- Avoiding lying down after eating
- Wearing loose, comfortable clothes
Is gastro-oesophageal reflux disease dangerous?
Gastro-oesophageal reflux disease is generally not dangerous in mild cases, but if ignored or left untreated, it may lead to serious complications such as inflammation of the oesophagus (esophagitis), narrowing of the oesophageal passage (strictures), or Barrett’s oesophagus, which may increase the risk of cancer. It can also cause persistent discomfort and affect quality of life. With appropriate treatment and lifestyle changes, GORD can be successfully controlled.What causes gastro-oesophageal reflux disease?
GORD can be caused by a weak or relaxed lower oesophageal sphincter (LES), which allows stomach acid to flow back into the oesophagus. Common factors that trigger symptoms include obesity, overeating, tobacco use, alcohol consumption, fatty or spicy foods, caffeine, and lying down after eating.How can I tell if I have IBS, IBD, or GORD?
To know if you have IBS, IBD, or GORD, look at your symptoms:- IBS: Bloating, abdominal pain, changes in bowel habits (diarrhoea, constipation, or both), without visible inflammation.
- IBD: Similar to IBS, but more severe, usually with bloody stools, fatigue, and weight loss due to inflammation or damage in the gut.
- GORD: Heartburn, acid reflux, chest discomfort, and sour taste in the mouth, particularly after eating or while lying down.
Is IBS a lifelong condition?
Yes, IBS is typically a lifelong condition, but symptom severity may vary over time. While there is no cure, many people effectively control it through dietary modifications, lifestyle changes, and medication.Can online doctors prescribe medication for GORD or IBS?
Yes, online doctors can prescribe medication for conditions like GORD and IBS after a proper consultation. They usually evaluate symptoms through video calls or questionnaires and may recommend treatments or suggest additional tests if necessary. With telehealth with registered doctors for fever treatment or gastro treatment, it is easy to get medical certificates online for the health condition. However, for complicated cases or when physical examinations are required, an in-person appointment may be required.Can I manage IBS, IBD, or GORD through diet alone?
Managing IBS, IBD, and GORD through diet alone can help, but usually it’s not enough by itself.- IBS: Diet can be helpful—avoiding trigger foods usually improves symptoms. Some people may need stress management or medication.
- IBD: Diet supports symptom relief but can’t control inflammation alone. Medical treatment is generally essential.
- GORD: Avoiding spicy and fatty foods helps, but medications are often needed for improvement.
How can online doctors help in managing IBS, IBD, or GORD?
Online doctors can assist in managing IBS, IBD, and GORD by providing accessible consultations, prescribing medications, and offering guidance on lifestyle and nutrition. They can monitor symptoms, adjust treatment plans, and offer follow-up care. For IBS and GORD, most cases can often be managed entirely online. For IBD, they help with symptom tracking and medication management, but may refer you to a specialist for diagnostic tests or advanced care.Reference
- Australian journal of general practice- reference link
- Crohn's and colitis organisation Australia - reference link
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This blog is for general informational purposes only and does not indicate that Hola Health provides all treatments or preventive measures mentioned. It is not intended to be a substitute for professional medical advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. For emergencies please immediately contact 000. Any medical topics discussed are intended to educate, not to imply availability through Hola Health.
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Call 000 for emergency or urgent medical help.
Address: 79 St Georges Terrace, Perth WA 6000
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