IBSIBD

IBSIBD is an informal, descriptive term used to refer to the overlap between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). It is not a formal diagnostic category in major medical classifications, but it is used to discuss patients with inflammatory bowel disease who continue to experience irritable-bowel-syndrome–like symptoms, or to describe the coexistence of both conditions in a given individual. In clinical use, IBSIBD typically refers to IBS-like symptoms such as abdominal pain or discomfort, altered bowel habits, bloating, and urgency in the setting of IBD that is in clinical remission or less active than during a flare.

IBD includes Crohn's disease and ulcerative colitis and involves objective mucosal inflammation; IBS is a functional disorder defined by symptom-based criteria (e.g., Rome IV). When IBS-like symptoms persist despite controlled inflammation, the clinical picture may be labeled as IBSIBD. The concept acknowledges that ongoing visceral hypersensitivity, altered gut motility, microbiome changes, and psychosocial factors can contribute to symptoms independent of active inflammation.

Evaluation aims to assess disease activity and rule out active inflammation or other conditions. Tools include assessment of IBD activity indices, fecal calprotectin, C-reactive protein, endoscopy when indicated, and consideration of infections or medication side effects. When inflammation is absent or mild, symptom-focused strategies are commonly used.

Management is usually multidisciplinary. It includes maintaining control of IBD with appropriate therapy, dietary adjustments such as a low FODMAP diet or tailored fiber regimens, antispasmodic agents, laxatives or antidiarrheal agents as needed, and symptom-directed therapies. Psychological support, stress management, and, in some cases, neuromodulators or gut-directed therapies may be considered.

Given limited formal guidelines specifically for IBSIBD, clinicians describe this overlap case-by-case, emphasizing individualized care and careful monitoring for disease activity to distinguish inflammatory flares from functional symptoms. Further research is ongoing to clarify prevalence, mechanisms, and optimal treatment strategies.