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In a captivating conversation on the H.V.M.N. Podcast, Dr. Latt Mansor and Dr. Mary Pardee delve into the world of digestive health, focusing on Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). With their expertise in gastroenterology, they shed light on the key differences between these two conditions, providing valuable insights for better understanding and management.

The discussion begins with an exploration of Irritable Bowel Syndrome (IBS), defined as a conglomeration of symptoms rather than a specific disease. Dr. Pardee explains that individuals diagnosed with IBS often experience abdominal discomfort, bloating, and changes in stool frequency or consistency. She introduces the Bristol Stool Chart as a tool used in gastroenterology to assess stool appearance and consistency. From hard, pellet-like stools to watery diarrhea, the chart helps in understanding the range of stool types associated with IBS.

Dr. Mansor humorously reflects on the unexpected turn of discussing poop early in the morning. Dr. Pardee continues, detailing the three subtypes of IBS: constipation-predominant, mixed-type, and diarrhea-predominant. She clarifies that a diagnosis of IBS requires the persistence of symptoms for at least six months. With a focus on each subtype, she highlights the challenges faced by individuals experiencing constipation, alternating constipation and diarrhea, or frequent diarrhea with looser stools.

Transitioning to Inflammatory Bowel Disease (IBD), Dr. Mansor asks about the distinction between IBS and IBD. Dr. Pardee explains that IBD refers to inflammatory conditions of the bowel, particularly ulcerative colitis. A colonoscopy is often performed to differentiate between IBS and IBD. In cases of IBD, inflammation and bleeding in the colon can be observed, along with symptoms such as persistent diarrhea and blood in the stool.

The conversation clarifies that while IBS is a symptom-based diagnosis, IBD involves an inflammatory response in the body, leading to visible signs of inflammation and bleeding. Dr. Pardee dismisses the misconception that chronic inflammation is associated with IBS, emphasizing the distinctive inflammatory nature of IBD.

Dr. Latt Mansor and Dr. Mary Pardee's discussion offers valuable insights into the world of digestive health, helping individuals gain a better understanding of Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). By distinguishing the symptoms, diagnostic procedures, and underlying inflammatory processes, they provide a roadmap for individuals to navigate these conditions with greater knowledge and informed decision-making.

In this episode, you'll discover:

  • Dr. Latt Mansor and Dr. Mary Pardee discuss the distinctions between Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) in a captivating conversation on the H.V.M.N. Podcast.
  • They explain that IBS is a collection of symptoms, including abdominal discomfort, bloating, and changes in stool frequency or consistency, while IBD involves inflammation of the bowel and can be diagnosed through procedures like colonoscopy.
  • The experts debunk the misconception that chronic inflammation is associated with IBS, highlighting the presence of visible inflammation and bleeding in cases of IBD. Their insights offer valuable guidance for understanding and managing these digestive conditions.

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Dr. Latt Mansor:

What is IBS actually, and what's the difference between IBS and IBD? What causes it?


Mary Pardee:

Sure. So IBs is irritable bowel syndrome. And so yesterday I diagnosed a girl with it. When you diagnose somebody with IVs, you say, you know you have irritable bowel syndrome, and they look at you and they're like, yeah, no shit. Like I told you, my bowel was irritable. Right? Like, I know that tells me absolutely nothing. Um and that's, that's a diagnosis in conventional medicine and just a labeling of. Symptoms, and that's what IBS is. It's a conglomeration of symptoms that somebody has. And so with ibs, usually somebody has abdominal discomfort is a hallmark symptom. So feeling like your abdomen is tender, especially when we palpate it on examination. Um, bloating is a very common symptom of ibs distension, or just the feeling of bloating. So that means your stomach is actually sticking out or just. Feels like there's pressure in there. Um, and then the other hallmark is changes in stool frequency or consistency. And so that means that you're either going to the bathroom very frequently or very infrequently. Mm-hmm. Um, so you're constipated or you have more diarrhea or your stools are really hard. Or they're really soft. And so we have this tool in gastroenterology called the Bristol Stool Chart, which if my patients are listening, they will know cuz they've seen it multiple times. but basically when someone comes into my office, I'm showing them pictures of poop and saying, what does your poop look like? And so it starts off Bristol stool chart number one, which are like those small little rabbit pellets, you know, really, really hard poops that are like, not even. Contained in one log and then it goes down to a seven, which is water.

Dr. Latt Mansor:

So that's like very watery diarrhea. Did you thought, do you think you're gonna have this conversation? No, never would have have thought. You know, I've studied metabolism and PhD and become the research these lead of HVMN and we talk about poop 10:00 AM in the morning. Yeah. Uh, hey, well you know what? We learn new things every day. We do. We do. And so anyway, tell me more, uh, about this scale. You know, you asked them, you know, how it looks like, sort of consistency and all that. So that's, syndrome, right? Mm-hmm. That's irritable bowel syndrome


Mary Pardee:

Yeah, exactly. And so there's, there's three different types. So you have ibs. Which is constipation predominant IBS. And that's somebody that is basically a one or or two on the Bristol stool chart. They're having harder stools and less frequent stools. Mm-hmm. And um, and that has to be for months going on. So it's not just, I was gonna ask, what's the period of time? Before they're, you know, obviously we go in and out of constipation or like diarrhea or whatever. Right. Um, how long does it have to be consistent in order to be categorized as that? Yeah, you need to have at least six months, um, that you've had these symptoms for. And so if it's just been a week, then. You know, especially a week of diarrhea, you're looking at could it be infectious or could it just be that you went through something really stressful and then you'll never have it again in your life. So this has been ongoing for months for somebody and it's not going away. Okay. And um, and then, so you have IBSC, then you have IBSM, which is a mixture. Mm-hmm. And that is, Is that somebody alternates from constipation and then they have diarrhea sometimes and they go back and forth. And then you have IBSD, which is diarrhea predominant, so that's somebody going to the bathroom multiple times per day and looser stools on the Bristol stool chart. Okay.

Dr. Latt Mansor:

And then what's the difference between IBS and IBD? So they're very different. They get confused because they sound similar, but they're actually pretty different.


Mary Pardee:

So IBD is inflammatory bowel disease. And so if you do a colonoscopy on somebody with IBS, which you usually will at some point, um, because you have to differentiate bet between the two of them. And so if somebody comes in with diarrhea and you don't know the cause of it and it's been ongoing and it hasn't responded to the first line treatments, then a lot of the times you're going to do a colonoscopy on them. Even somebody with constipation actually. And that's when you scope the colon. So you go through the rectum with a camera and you can see the whole colon in part of the small intestines as well. And in somebody with IBD, if they have ulcerative colitis, a form of IBD, you'll see inflammation of that colon. Um, so somebody with i b D will come in and they usually have diarrhea. Sometimes they can have constipation, but usually diarrhea. Um, but they'll have blood in the stool a lot of the times, and you should not have that with ibs. = And so the difference is this inflammatory response that's happening in the body with IBD that you should not see with ibs. And so, You know, we're talking about like myths and things that just people throw out there, but a lot of people with IBS will come and say, oh, I'm so inflamed. It must be the inflammation. And that's not really the cause for ibs, but it is the cause for IBD where there's a higher level of inflammatory cytokines that are, that are there, that are causing this inflammation. And then you'll actually get bleeding of the GI tract.

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