What gets mistaken for IBD?

What Gets Mistaken for IBD?

Inflammatory Bowel Disease (IBD) is a serious, lifelong condition that mainly includes Crohn's disease and ulcerative colitis. These diseases cause chronic inflammation in the digestive tract and can lead to symptoms such as ongoing diarrhea, abdominal pain, fatigue, weight loss, and blood in the stool.

Because many digestive and non-digestive conditions share similar symptoms, IBD is often mistaken for other health problems—especially early on. Understanding what can look like IBD is important, because the treatments, risks, and long-term outlook can be very different.

Below is a clear, medically accurate overview of the most common conditions that are mistaken for IBD, based on guidance from major gastroenterology and medical organizations.

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Irritable Bowel Syndrome (IBS)

IBS is the most common condition mistaken for IBD.

IBS affects how the gut functions, while IBD causes visible inflammation and tissue damage. Despite this major difference, the symptoms can overlap.

Shared symptoms

• Abdominal pain or cramping
• Diarrhea, constipation, or both
• Bloating and gas
• Mucus in the stool

Key differences

• IBS does not cause inflammation, bleeding, or intestinal damage
• IBS does not increase cancer risk
• IBS symptoms often improve after bowel movements
• Blood tests and colonoscopy are usually normal in IBS

Because IBS is far more common than IBD, many people are initially told they have IBS before further testing reveals inflammation.

If you're experiencing ongoing digestive symptoms and want to understand whether they align more with Irritable Bowel Syndrome (IBS), a free AI-powered symptom checker can help you evaluate your symptoms and determine your next steps.

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Infectious Colitis (Gut Infections)

Short-term infections of the intestines are another frequent cause of IBD-like symptoms.

Common causes

• Bacterial infections (such as Salmonella or Campylobacter)
• Viral gastroenteritis
• Parasitic infections

Why it looks like IBD

• Diarrhea that may be severe
• Abdominal pain
• Fever
• Blood or mucus in the stool

How it differs from IBD

• Symptoms usually improve within days or weeks
• Inflammation resolves once the infection clears
• Stool tests can often identify the cause

However, some infections can trigger IBD in people who are already genetically at risk, which is why follow-up is important if symptoms persist.

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Celiac Disease

Celiac disease is an autoimmune condition triggered by gluten, and it is frequently confused with IBD.

Shared symptoms

• Chronic diarrhea
• Weight loss
• Abdominal pain
• Fatigue
• Nutrient deficiencies

Important differences

• Celiac disease affects the small intestine only
• Symptoms improve with a strict gluten-free diet
• Blood tests and small bowel biopsies help confirm diagnosis

Unlike IBD, celiac disease does not cause patchy inflammation throughout the digestive tract, but untreated cases can still lead to serious complications.

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Lactose Intolerance and Other Food Intolerances

Food intolerances are very common and often mistaken for IBD, especially in younger adults.

Typical symptoms

• Bloating
• Gas
• Diarrhea
• Abdominal discomfort

Key clues it's not IBD

• Symptoms occur after eating specific foods
• No blood in stool
• No ongoing inflammation
• Symptoms improve when trigger foods are avoided

Food intolerances can coexist with IBD, which can make diagnosis more complicated.

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Diverticular Disease

Diverticular disease involves small pouches forming in the colon, which can sometimes become inflamed (diverticulitis).

Overlapping symptoms

• Abdominal pain (often on the left side)
• Fever
• Changes in bowel habits
• Nausea

Differences from IBD

• More common in older adults
• Inflammation is usually localized
• Symptoms often come on suddenly

Imaging studies such as CT scans help distinguish diverticulitis from IBD.

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Microscopic Colitis

Microscopic colitis is a lesser-known cause of chronic diarrhea and is often mistaken for IBD or IBS.

Why it's confusing

• Chronic, watery diarrhea
• Normal-looking colon during colonoscopy
• No visible ulcers or bleeding

How it's diagnosed

• Biopsies taken during colonoscopy
• Inflammation seen only under a microscope

Unlike IBD, microscopic colitis does not cause deep tissue damage but still requires medical treatment.

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Colon Cancer and Other Cancers

Certain cancers can produce symptoms that resemble IBD, especially in early stages.

Possible overlapping symptoms

• Blood in the stool
• Unexplained weight loss
• Changes in bowel habits
• Abdominal pain

Why this matters

• IBD increases colon cancer risk over time
• Cancer-related symptoms may be subtle at first
• Delayed diagnosis can be life-threatening

This is one reason persistent symptoms should never be ignored, even if they seem mild.

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Endometriosis (in Women)

Endometriosis can closely mimic IBD, especially when it affects the bowel.

Shared symptoms

• Abdominal pain
• Diarrhea or constipation
• Bloating
• Pain during bowel movements

Key differences

• Symptoms may worsen around menstruation
• Imaging and gynecologic evaluation are often needed
• Inflammation is outside the intestine, not inside

Many women with endometriosis are misdiagnosed with IBS or suspected IBD for years.

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Medication Side Effects

Certain medications can cause gut inflammation or irritation that looks like IBD.

Common culprits

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Some antibiotics
• Chemotherapy drugs

Important clues

• Symptoms start after medication use
• Improve when the drug is stopped
• No long-term inflammatory pattern

A detailed medication history is essential during evaluation.

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Why Proper Diagnosis Matters

IBD is not just a digestive issue—it can affect joints, skin, eyes, liver, and overall health. Treating IBD incorrectly or missing a more serious diagnosis can lead to:

• Ongoing inflammation and tissue damage
• Nutritional deficiencies
• Increased risk of complications
• Delayed treatment of life-threatening conditions

Diagnosis typically involves:

• Blood tests
• Stool tests
• Imaging
• Colonoscopy with biopsies

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When to Speak to a Doctor

You should speak to a doctor as soon as possible if you experience:

• Blood in your stool
• Unexplained weight loss
• Persistent diarrhea lasting more than 2–3 weeks
• Severe or worsening abdominal pain
• Fever with bowel symptoms
• Nighttime symptoms that wake you up

These can signal IBD or another serious condition that requires medical care.

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Final Thoughts

Many conditions can be mistaken for IBD because digestive symptoms often overlap. While some causes are mild and manageable, others—including IBD itself—can be serious if left untreated. Paying attention to symptom patterns, duration, and warning signs is key.

If your symptoms are ongoing, worsening, or concerning, do not rely on guesswork alone. Consider tools like a symptom checker for initial insight, but always follow up and speak to a doctor to rule out anything life-threatening or serious and to get the right diagnosis and care.