Many people with multiple sclerosis (MS) are also living with another health condition. Inflammatory bowel disease (IBD) and MS are both autoimmune diseases that cause inflammation. Research shows that people with MS are more likely to develop an IBD — such as Crohn’s disease or ulcerative colitis — than those without MS.

Keep reading to learn more about the link between IBD and MS.

What Is IBD?

IBD refers to a group of conditions that cause inflammation in the gastrointestinal (digestive) tract. The two most common types of IBD are Crohn’s disease and ulcerative colitis. While Crohn’s disease can affect any part of the digestive tract, it tends to affect deeper layers of the small intestine. Ulcerative colitis usually causes inflammation in the colon and rectum. IBD happens when the immune system begins to mistakenly attack healthy tissues in the gastrointestinal tract.

What Is MS?

MS is a long-term condition that affects the brain and spinal cord, which make up the central nervous system (CNS). The CNS controls movement, sensation, and thinking. In MS, the immune system mistakenly attacks myelin — a protective coating that covers nerve fibers in the CNS. This can slow down or block signals between the brain and the rest of the body.

Just like IBD causes inflammation in the digestive tract, MS causes inflammation in the nervous system. This inflammation can lead to symptoms like fatigue, numbness, muscle weakness, vision problems, and trouble with balance. MS affects everyone differently — some people have mild symptoms while others may have more challenges.

Is There a Connection Between IBD and MS?

Research shows that people with multiple sclerosis may have a higher chance of developing IBD than those without MS. A study combining data from several sources found that people with either MS or IBD have about a 50 percent higher risk for developing the other condition compared to people without it. Although the risk is higher, most people with one condition won’t develop the other.

Both IBD and MS happen because the immune system mistakenly attacks healthy tissue. Scientists believe this may happen because of shared triggers — like certain genes or factors in the environment — that raise the risk for both conditions.​

The “gut-brain axis” is a term used to describe the communication network between the digestive system and the brain. When this connection isn’t working right, it may affect both gut and brain health. For example, changes in gut bacteria can affect immune responses and may play a role in both IBD and MS.

Can You Be Diagnosed With Both Conditions?

While uncommon, it’s possible to be diagnosed with both MS and an IBD. Some people first experience symptoms of one condition and later develop signs of the other. Having one autoimmune disease may increase your risk of developing another.

Known risk factors for both MS and IBD include family history, vitamin D deficiency, and smoking. Researchers continue to explore how these and other factors might contribute to the overlap between the two conditions.

If you’re living with one of these conditions and notice new or changing symptoms, talk to your doctor. Getting an early and accurate diagnosis of both conditions can help you get the care you need.

Shared Symptoms and Challenges

​Living with both MS and IBD can be uniquely challenging, as these conditions share several symptoms. Understanding these shared symptoms is important for managing them effectively and maintaining your quality of life.​

Fatigue

Fatigue is a common and often debilitating symptom in both MS and IBD. Fatigue is more than simply feeling tired. Rather, it’s an overwhelming sense of exhaustion that doesn’t go away with rest and can interfere with daily activities.

About 80 percent of people with MS experience fatigue. This may be due to how changes in the central nervous system affect energy levels. Similarly, nearly 80 percent of people with active IBD and about half of those in remission report experiencing fatigue. This may be caused by inflammation, nutrient deficiencies, and sleep disturbances. ​

Pain

Pain affects people with MS and IBD in different ways, but it’s common in both conditions. People with MS may experience neuropathic pain, such as burning sensations or muscle spasms, due to nerve damage. In IBD, abdominal pain is a key symptom, caused by inflammation and ulceration in the digestive tract. Treating pain well means using different approaches based on the type and cause of the pain.

Cognitive Difficulties (Brain Fog)

Both MS and IBD can cause cognitive impairments, often referred to as “brain fog” or “cog fog.”

In MS, this may include trouble with memory, attention, and problem-solving, caused by demyelination (nerve damage) in the brain.

In IBD, brain fog isn’t as well studied, but many people report similar cognitive challenges, especially during flare-ups. This may be linked to inflammation throughout the body, which can affect how the brain works. ​

Emotional Health

Living with chronic illnesses like MS and IBD can have a significant impact on your emotions. It is common for people with these conditions to develop depression and anxiety. This can come from the stress of managing a long-term illness as well as from the way inflammation affects the brain. Taking care of your mental health is just as important as treating physical symptoms when you have MS or IBD. ​

Navigating Overlapping Symptoms

When you have both MS and IBD, symptoms from one condition can make the other feel worse. For example, fatigue from one illness can add to fatigue from the other. That’s why it helps when different doctors — like a neurologist, gastroenterologist, and mental health provider — work together to create a care plan that supports your overall health.

With the right support and tools, people living with both MS and IBD can manage these challenges and feel better day to day.

Treating MS and IBD Together

MS and IBD are both caused by inflammation, but they need different treatments. Sometimes, a medicine that helps one condition might make the other worse. Right now, there are no clear guidelines for treating both conditions at the same time, so care needs to be tailored to each person.

Some MS treatments can make IBD worse. For example, interferon beta drugs and alemtuzumab (Lemtrada) may cause IBD symptoms to flare by affecting the immune system or gut bacteria. Likewise, some treatments for IBD — especially anti-TNF drugs — have been linked to more severe MS symptoms or a higher risk of being diagnosed with MS.

However, a few treatments may help both MS and IBD. Natalizumab (Tysabri) and natalizumab-sztn (Tyruko), its biosimilar (a similar drug made by a different company), are both approved to treat MS and moderate to severe Crohn’s disease. Corticosteroids, often used during flare-ups, may also reduce inflammation in either condition.

Managing Bowel Symptoms with IBD and MS

Besides taking medications, it’s important to manage symptoms that affect daily life — especially bowel problems. These problems can be caused by IBD itself or by nerve damage from MS that affects how your digestive system works. Your healthcare team can help you find the best ways to manage these symptoms and improve your comfort.

Drinking plenty of fluids and getting regular exercise can help with constipation, which is common in MS. If you have diarrhea or stomach pain — more common in IBD — your doctor might suggest changes to your diet. Some people with MS or IBD also have trouble with bowel control. Pelvic floor exercises and sticking to a regular bathroom schedule may help.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 266,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with both MS and IBD? Share your experience in the comments below, or start a conversation by posting on your Activities page.