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So your stomach is being dramatic on the regular, and you're starting to wonder if there’s something wrong beyond those leftovers that didn't agree with you or that third cup of coffee you’ve been drinking each day.
You’ve heard how colon cancer rates are increasing in people under age 50, and you’re getting a little concerned. How can you tell the difference between symptoms of colon cancer and something like irritable bowel syndrome (IBS), which is not dangerous (but uncomfortable), or inflammatory bowel disease (IBD), which can be a serious issue?
We asked experts and have answers to all your gut symptom questions.
Three persistent gut health conditions
Although IBS, IBD and colon cancer all involve your gut, the conditions are quite different.
IBS is a disorder of gut-brain interaction, meaning the nerves in your gut and brain aren’t communicating properly with each other. But if someone were to look inside your colon, there would be no visible signs of IBS. It’s common for people with IBS to get diarrhea or constipation often, or cycle between the two.
IBD is a group of diseases caused by chronic inflammation in the digestive tract. The most common types of IBD are Crohn’s disease and ulcerative colitis. These conditions are more serious because they can cause damage to the lining of your colon and also lead to the development of polyps, which can become cancerous.
Colon cancer is the growth of cancerous tumors in the tissue of the colon or rectum. The tumors often start as polyps, which can be removed if they’re found. There are more than 150,000 new cases each year in the United States, according to the American Cancer Society.
“The really important thing is that if someone has gastrointestinal symptoms, they should see a doctor, and if symptoms persist, the person should get referred to a gastroenterologist,” says Rachel Issaka, MD, a gastroenterologist at UW Medicine and Fred Hutch Cancer Center. “There are tests we have to distinguish between these three conditions.”
What are the differences between IBS, IBD and colon cancer?
Unfortunately, the three conditions share a lot of symptoms, which can make it frustrating if you have gut symptoms.
Symptoms that can happen in IBS, IBD or colon cancer include:
- Frequent stomach pain or cramping
- Lasting stool changes like diarrhea, constipation or both
- Feeling like you can’t completely empty your bowels
- Nausea and vomiting
- Unintended weight loss
- Constantly feeling tired and weak
- Bloating
The symptoms may show up differently, though, depending on their cause. Feeling crampy 24/7? That’s more common with colon cancer or IBD, whereas cramps right before a bowel movement happen more with IBS.
Some symptoms are unique to each condition, too. Being gassy is more common with IBS, whereas blood in the stool is likelier to be caused by IBD or colon cancer.
Symptom duration can be a clue, too. If you alternate between constipation and diarrhea, it’s probably IBS. Constant diarrhea? More likely IBD. If you’re having issues constantly, not just after eating, or if the issues are progressively worsening, that’s also more consistent with IBD.
When should I see a doctor for my gut issues?
You should feel comfortable talking with your doctor about any symptoms you’re having, even if you don’t think they’re serious. But if you have more alarming symptoms that are affecting your ability to function, that’s a red flag.
“We’re most concerned when symptoms persist for longer than about two weeks, especially if they are accompanied by ‘alarm features’ such as blood in the stool, unintentional weight loss, diarrhea or pain, waking someone from sleep or unexplained anemia,” says Jeffrey Jacobs, MD, a gastroenterologist at UW Medicine who specializes in IBD treatment.
Your primary care provider may try prescribing medications to help with your symptoms, or they may order some imaging tests to see what’s going on in your gut. If your symptoms are more serious, doctors may recommend a stool test or colonoscopy.
IBS is the most common of the three conditions, but it’s also a diagnosis of exclusion, meaning there isn’t a test for IBS, so doctors have to rule out other possibilities first.
“It’s also important to note that IBS and IBD can coexist,” says Jacobs. “In the general population, roughly 10% of people would meet criteria for IBS. Among people with IBD, that number is likely closer to 30%.”
Trust your gut
Ultimately, if your gut is uncomfortable more often than not, it’s a good idea to get it checked out. In the meantime, pay close attention to your symptoms, how long they last, and if anything triggers them.
“Regardless of what gut symptoms you’re having, if you’re able to keep a diary of those symptoms and take that with you to your clinical visit, that can be helpful for your team to figure out what’s going on,” says Issaka.
Gut problems aren’t fun: They can be uncomfortable, embarrassing, and sometimes even scary. By tracking your symptoms and talking with experts when needed, you’ll ensure you’re staying on top of any issues as they arise — after all, no (healthy) guts, no glory.
