91: IBS vs. IBD - Could SIBO Be the Missing Link Between the Two

IBS and IBD are often confused with one another, but they are not the same condition—and understanding the difference may be one of the most important steps in making sense of chronic gut symptoms.In this episode, Josh Dech breaks down the distinction between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. He explains why IBS is generally considered a functional disorder, while IBD involves structural changes such as inflammation, ulceration, strictures, and tissue damage.The conversation also explores the surprising similarities between IBS and IBD. Both can involve abdominal pain, diarrhea, constipation, urgency, bloating, dysbiosis, gut-barrier disruption, environmental triggers, stress, lifestyle factors, and medication-related aggravation. Josh also discusses why people with IBD can continue experiencing IBS-type symptoms even when their inflammatory disease is considered to be in remission.A major focus of the episode is the relationship between IBS and SIBO—small intestinal bacterial overgrowth. Josh highlights research suggesting substantial overlap between IBS and SIBO, particularly in people experiencing mixed constipation-and-diarrhea symptoms.From there, he introduces a provocative hypothesis: could some cases of IBD potentially develop following an earlier IBS/SIBO pattern? Josh walks through his own population-attributable-risk thought experiment and arrives at a theoretical range suggesting that a substantial percentage of IBD could potentially be connected to this progression.Importantly, Josh emphasizes that this is a theory requiring further research—not an established conclusion.The episode ultimately raises a bigger root-cause question: if certain forms of gut dysfunction can be identified earlier, could earlier investigation and intervention potentially change the trajectory of chronic inflammatory gut disease?For anyone interested in gut health, the microbiome, inflammation, immune-system dysfunction, SIBO, IBS, Crohn’s disease, ulcerative colitis, or root-cause approaches to chronic illness, this episode provides a provocative framework for thinking about where inflammatory bowel disease may begin—and whether there could be opportunities to intervene earlier.TOPICS DISCUSSED:IBS Vs. IBD: Fundamental Differences And SimilaritiesIBS Symptoms, Diagnosis, Subtypes And Rome CriteriaSIBO And Its Relationship To IBSIBD Symptoms, Inflammation And Structural DamageCrohn’s Disease Vs. Ulcerative ColitisShared Triggers: Stress, Environment, Medications And LifestyleThe Gut-Brain Axis, Dysbiosis And Gut-Barrier DysfunctionIBS/IBD Prevalence And Diagnostic ChangesJosh’s IBS → SIBO → IBD Population-Risk Thought ExperimentWant help with your IBD?Schedule a call with me and my teamJoin the Reversing Crohn's and Colitis Naturally CommunityVisit our Website:gutsolution.caVideo Podcast:Watch the video podcast on YouTubeFollow me on Social Media:Facebook: @joshdech.healthInstagram: @joshdech.healthJoin my free Facebook group: IBD Support and SolutionsSupport the show