Department of Health confuses IBS with IBD in Parliament

05 February 2016

The Chief Executive of Crohn’s and Colitis UK, has written to the Public Health Minister Jane Ellison MP, to highlight their dismay and disappointment that officials at the Department of Health publicly confused Irritable Bowel Syndrome (IBS) with Inflammatory Bowel Disease (IBD).

In a response to a Parliamentary Question by Jim Shannon MP of the Democratic Unionist Party, officials at the Department of Health confused Irritable Bowel Syndrome (IBS) with Inflammatory Bowel Disease (IBD) - which are two completely different conditions.

Question by Jim Shannon MP:

To ask the Secretary of State for Health, how many people of each age group and gender were diagnosed with irritable bowel syndrome in each of the last five years.

Response from Jane Ellison MP, Parliamentary Under Sectary of State:

Data relating to the total number of people diagnosed with irritable bowel syndrome (IBD) in each of the last five years is not collected.

The two main forms of IBD are Crohn’s disease and ulcerative colitis. Ulcerative colitis only affects the large intestine whereas Crohn's disease affects the whole of the digestive system.

The National Institute for Health and Care Excellence guidance indicates that ulcerative colitis has an incidence in the United Kingdom of approximately 10 per 100,000 people annually, and a prevalence of approximately 240 per 100,000.

This amounts to around 146,000 people in the UK with a diagnosis of ulcerative colitis. In addition to this, there are currently at least 115,000 people in the UK with Crohn's disease.

The confusion between IBS and IBD is something that Crohn’s and Colitis UK campaign on rigorously, as the diagnosis of Crohn’s Disease or Ulcerative Colitis (the main conditions known as Inflammatory Bowel Disease or IBD) can be significantly delayed due to the fact that some GPs diagnose a patient with potential IBD as having IBS and therefore do not refer them promptly enough to a specialist in secondary care where they can be accurately diagnosed as having IBD and be appropriately treated.

Similar symptoms like diarrhoea and the regular and urgent need to use the toilet can lead to misdiagnosis and therefore often the health of someone suffering with IBD has to get significantly worse before they are referred into secondary care. This delay may also lead to such a deterioration in a person’s condition that expensive hospitalisation is required.  This is borne out in The IBD 2020 survey which found that 58% of those with Crohn’s Disease and 40% of those with Ulcerative Colitis in the UK had visited A&E because of their symptoms more than once before they were diagnosed.

This is why Crohn’s and Colitis UK campaign and work with NHS Trusts and Health Boards across the UK to increase the effective use of a faecal calprotectin stool test.  Faecal calprotectin is recommended by NICE as a cost-effective option which can help clinicians with the differential diagnosis of IBD and IBS.  This can enable quicker referral to specialist care for those with suspected IBD and reduce unnecessary endoscopy for those with IBS.

It is extremely concerning that the Department of Health themselves have failed to distinguish the difference between IBD and IBS in this very public response especially given the many layers of procedural sign off that Parliamentary Questions go through.

I have written to the Health Minister to raise this issue as a serious concern and to seek a meeting to discuss working together to address try and improve this situation in the future to ensure that undiagnosed patients with IBD or IBS would all benefit from quicker and more accurate diagnosis of their condition.

David Barker, Chief Executive
Crohn's and Colitis UK