IBD and MS: Is There a Link?
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Is There a Link Between Inflammatory Bowel Disease (IBD) and Multiple Sclerosis (MS)?

Is There a Link Between Inflammatory Bowel Disease (IBD) and Multiple Sclerosis (MS)?
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Updated on August 11, 2025
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Inflammatory bowel disease (IBD) and multiple sclerosis (MS) are both considered immune-mediated, inflammatory diseases.

The cause of both conditions remains unknown, though both have been linked to genetic and environmental factors, as well as potential disruptions of the gut microbiome. They also share a number of risk factors, and both can cause bowel problems.

Research suggests people with IBD have an increased risk of MS and vice versa, though it’s relatively rare for a person to be diagnosed with both. Although the two conditions are linked, the exact nature of their connection is unknown.

Prevalence of MS and IBD

According to a systematic review and meta-analysis of 17 studies, the prevalence of MS in patients with IBD is 0.2 percent, while the prevalence of IBD in patients with MS is 0.6 percent.

People with MS had a higher prevalence of IBD than those in a control group (researchers found a similarly high risk of Crohn’s disease or ulcerative colitis), and people with IBD had a higher prevalence of MS than those in the control group.

“We don’t know how to predict who with IBD is going to get MS or vice versa, but it’s something doctors need to think about when we’re prescribing medications or treatments,” says Gil Melmed, MD, the director of inflammatory bowel disease clinical research at Cedars-Sinai Medical Center in Los Angeles.

What Is Inflammatory Bowel Disease?

IBD refers to a group of conditions, the most common of which are ulcerative colitis (UC) and Crohn’s disease (CD).

UC and CD both lead to similar, episodic symptoms, including:

  • Abdominal pain
  • Diarrhea
  • Blood in the stool
  • Fatigue
  • Unintentional weight loss

IBD is often referred to as an autoimmune disease, but Dr. Melmed prefers the term immune-mediated. “In IBD, the body is not attacking itself per se, but the immune system is being triggered by bacteria commonly found in the gut and going into overdrive,” he says.

What Is Multiple Sclerosis?

In MS, it’s generally thought that the immune system attacks the protective sheath, or myelin, around nerve fibers, which causes communication problems between your brain and the rest of your body. Over time, it can cause permanent damage to the nerve fibers.

Signs and symptoms of MS vary widely depending on the location and severity of nerve fiber damage, but they commonly include:

  • Tingling or numbness in at least one limb
  • Lack of coordination or trouble walking
  • Visual disturbances (blurriness, loss of vision)
  • Sexual dysfunction
  • Bowel and bladder complications

IBD and MS: Some Overlapping Symptoms

Bowel symptoms similar to those caused by IBD are common in MS, though just how common isn’t well established. A study published in 2023 examined data from 369 people with MS and found that just under half of them reported bowel symptoms.

Meanwhile, others estimate that 7 out of 10 people with MS experience bowel symptoms. Constipation and incontinence are commonly among them.

Melmed says that people who have IBD or MS shouldn’t necessarily rush to be tested for the other condition unless their symptoms strongly indicate they might have both. “It’s not an easy, clear-cut diagnosis in someone who isn’t symptomatic, so it isn’t feasible to do MRI scans for MS in everyone with IBD,” he says.

Given the increased prevalence of MS in people who have IBD, Brian Barry, MD, an attending neurologist at MedStar Washington Hospital Center in Washington, DC, recommends that people with IBD get a referral to a neurologist if they experience weakness, tingling or numbness, or trouble walking.

How Are IBD and MS Connected?

“We are not totally certain how [the gut] directly interacts with MS,” says Dr. Barry. But it's known that the gut does play a large role in both the immune and nervous systems.

Barry says this is important because anti-tumor necrosis factor (TNF) therapy is associated with the potential worsening of MS and other demyelinating neurological conditions like transverse myelitis and optic neuritis.

 Anti-TNF therapies, also known as biologics, are among the most common classes of medication prescribed for IBD.

On the other hand, there are also classes of drugs that are effective in both IBD and MS. Natalizumab is approved for both MS and CD, and ozanimod is approved for MS and UC, Melmed says.

“Research has shown that the immune system is shaped by events in the gut and that immune cells in the gut can actually travel all the way to the central nervous system,” says Carlos Camara-Lemarroy, MD, an assistant professor at the University of Calgary’s Hotchkiss Brain Institute in Alberta. “This is why the gut-brain axis may be important for the development of MS and other inflammatory conditions.”

Risk Factors for IBD and MS

MS and IBD share several common risk factors:

  • Smoking
  • Higher socioeconomic status
  • Deficiency in vitamin D
  • Residence in colder climates
Other common risk factors include:

  • Race and ethnicity, with white people generally being at higher risk for both MS and IBD
  • Age, with IBD most often developing before age 30, and the onset of MS most often occurring between ages 20 and 40
  • Family history; people with a blood relative with MS are at higher risk for the condition
Certain viral infections, including Epstein-Barr — which causes infectious mononucleosis, more commonly known as mono — are linked to MS. And women are more likely to develop MS than men.

Meanwhile, the use of antibiotics has been linked to the development of IBD.

The Takeaway

  • IBD and MS are both immune-mediated, inflammatory diseases, and both have been linked to the gut.
  • IBD and MS may be connected in some way, but more research is needed to explore this link.
  • The two conditions have similar risk factors and overlapping symptoms.
  • Some IBD medications can worsen MS, but others can effectively treat both conditions.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Bezzio C et al. Inflammatory Bowel Disease and Immune-mediated Inflammatory Diseases: Looking at the Less Frequent Associations. Therapeutic Advances in Gastroenterology. July 28, 2022.
  2. Wang X et al. Multiple Sclerosis and Inflammatory Bowel Disease: A Systematic Review and Meta‐analysis. Annals of Clinical and Translational Neurology. January 29, 2022.
  3. Inflammatory Bowel Disease (IBD). Cleveland Clinic. May 20, 2024.
  4. Multiple Sclerosis. Mayo Clinic. November 1, 2024.
  5. Bourre B et al. Multiple Sclerosis and Bowel Symptoms: Frequency and Barriers to Their Management. Multiple Sclerosis and Related Disorders. August 4, 2023.
  6. Bowel. MS Society UK.
  7. Li L et al. Risk of Multiple Sclerosis Among Users of Antitumor Necrosis Factor α in 4 Canadian Provinces: A Population-Based Study. Neurology. February 2023.
  8. Inflammatory Bowel Disease (IBD). Mayo Clinic. December 18, 2024.
  9. Faye AS et al. Antibiotic Use as a Risk Factor for Inflammatory Bowel Disease Across the Ages: A Population-Based Cohort Study. Gut. January 9, 2023.
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Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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Ajai Raj

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Ajai Raj is a reporter specializing in medical science, health, and technology. His work has appeared in Popular Science, Scientific American Mind, The Scientist, and the New York Daily News, as well as a number of medical trade journals.
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