An international panel of gastroenterology experts has published consensus guidance on identifying and managing irritable bowel syndrome (IBS) like symptoms in patients with inflammatory bowel disease (IBD) who are otherwise in remission. The statement, reported by the HMP Global Learning Network, responds to a persistent clinical challenge affecting a substantial minority of patients whose bowel symptoms continue despite controlled inflammation.
IBD, encompassing Crohn’s disease and ulcerative colitis, is defined by chronic inflammation of the gastrointestinal tract that can be brought under control through medical therapy, with remission typically confirmed through a combination of symptom resolution, blood or stool markers, and endoscopic findings. However, clinicians have long observed that some patients continue to report bowel symptoms, such as abdominal pain, bloating, and altered bowel habit, that closely resemble IBS even after inflammatory activity has resolved. Distinguishing these functional symptoms from a genuine disease flare is clinically difficult, as the two can present in overlapping ways, and mismanagement in either direction carries consequences for patients and health services alike.
According to the panel, which comprised thirteen international specialists, IBS-like symptoms affect an estimated twenty to thirty per cent of patients with IBD who are in remission. The consensus statement was developed to bring clarity to this overlap, addressing how these symptoms should be recognised, characterised, and distinguished from ongoing inflammatory activity. The panel’s work reflects a recognition that standard markers of IBD remission, including endoscopic healing and normalised inflammatory markers, do not always correspond with a patient’s symptomatic experience. By formalising expert agreement on this topic, the statement aims to provide a shared reference point for clinicians navigating cases where objective disease control and subjective symptom burden diverge. The full detail of the panel’s specific recommendations was not disclosed in the reporting reviewed for this article.
For clinicians managing IBD, the distinction between residual inflammation and IBS-like overlap has direct implications for care. Attributing ongoing symptoms to active disease when inflammation is genuinely quiescent risks unnecessary escalation of immunosuppressive or biologic therapy, while dismissing symptoms as purely functional risks missing a genuine flare. For patients, having a recognised framework for these symptoms may help validate an experience that has historically been difficult to categorise within routine follow-up. Gastroenterologists, IBD nurses, and dietitians working with this patient group may find the consensus statement a useful point of reference when symptoms and objective disease markers do not align.
Reference
International Consensus Targets IBS-Like Symptoms in Inflammatory Bowel Disease. HMP Global Learning Network [Internet]. Available from: https://www.hmpgloballearningnetwork.com/site/aibdnet/consensus-statements/international-consensus-targets-ibs-symptoms-inflammatory-bowel
This article is a journalistic summary for informational purposes only. It does not constitute clinical advice or a recommendation to alter treatment decisions.