Published on 1 November 2021

    Chronic tummy troubles? Learn whether symptoms point to a chronic stomach condition such as Irritable Bowel Syndrome (IBS) or to a more serious one known as Inflammatory Bowel Disease (IBD).

    All of us suffer from the occasional change in bowel habits. Most often, these are caused by diet imbalances, lack of exercise, hormones or mild illness.

    However, if bowel problems are chronic – lasting beyond a week or two – and if they are accompanied by severe pain and bloody stools, it may warrant seeking medical advice.

    Getting to the gut of the issue

    Two common reasons for chronic stomach issues are Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD).

    These two stomach complaints share some similar symptoms but are actually different problems with different treatments and outcomes. 

    Dr Jessica Hay Tang, Family Physician, Clementi Polyclinic, National University Polyclinics (NUP) shared:

    • IBS is a functional gastrointestinal disorder that is chronic. Symptoms vary in severity and duration from person to person. IBS does not cause changes in bowel tissue or increase the risk of colorectal cancer.

    • IBD is an umbrella term for inflammatory gastrointestinal diseases that cause chronic inflammation of the digestive tract. These include ulcerative colitis and Crohn’s disease. IBD can increase the risk of colon cancer due to the ongoing active inflammation.

    According to Dr Phua Yiyong, Family Physician, Choa Chu Kang Polyclinic, NUP, IBS can affect people of all ages. “Population studies reveal a preponderance towards women and those 40 years of age and younger,” he explained. Other risk factors include a family history and co-existing morbidities of depression and anxiety. In Singapore, about 20% of people suffer from IBS.

    The incidence of IBD is not as high, but the disease is reportedly on the rise, and is most common in those aged between 20 to 40 – and in rare cases, children too.

    Both IBS and IBD can seriously impact quality of life. In the case of IBD, it can be a serious problem and can increase the risk of cancer. This underscores the importance of consulting with a doctor so that the problem can be diagnosed and managed.

     Irritable Bowel SyndromeInflammatory Bowel Disease 
     Key characteristics & symptoms
    Abdominal pain and/or cramps, gas, bloating, chronic constipation and/or diarrhoea that may be relieved by a bowel movement.Abdominal pain and/or cramps, gas, bloating, chronic constipation and/or diarrhoea that is not typically relieved by a bowel movement. As well as blood in the stool, anaemia, fatigue and weight loss. 
    Diagnosis for IBS is based on symptoms as well as a person’s medical history.Diagnosis is made via a combination of blood and stool tests as well as endoscopic procedures and imaging (x-ray, CT scan or MRIs) to confirm the presence of inflammation. 
     Treatment and management options
    IBS can be managed through education about the condition, its triggers, lifestyle changes and self-care techniques, which can reduce the severity of symptoms and improve the quality of life.

    These include:

    • Avoidance of triggers such as certain foods known to trigger IBS, such as dairy, caffeine, deep-fried or spicy foods

    • Stress management and psychological support

    • Supplements such as fibre and/or probiotics

    Treatment for IBD depends on the causes of the inflammation as well as its severity.

    These include:

    • Anti-inflammatory drugs

    • Immunosuppressants that control the immune reaction that triggers inflammation

    • Biologic drugs that neutralise the proteins that cause inflammation

    • Medication for symptomatic relief 

    • Surgery may be recommended in serious cases of IBD to remove badly damaged areas of the digestive tract 


    In consultation with Dr Jessica Hay Tang, Family Physician, Clementi Polyclinic, NUP and Dr Phua Yiyong, Family Physician, Choa Chu Kang Polyclinic, NUP.


    Related Articles