Irritable Bowel Syndrome (IBS)

IBS is a functional GI disorder characterized by abdominal pain related to bowel movements and altered stool form/frequency without structural disease. It involves gut-brain axis dysregulation, visceral hypersensitivity, immune activation, and microbiome changes. Subtypes: IBS-C (constipation), IBS-D (diarrhea), IBS-M (mixed), IBS-U (unclassified).

Symptoms

• Recurrent abdominal pain (≥1 day/week for 3 months) associated with defecation or change in stool form/frequency
• Bloating, gas, mucus in stool
• Sense of incomplete evacuation, urgency, or straining
• Extraintestinal: fatigue, sleep disturbance, anxiety, pelvic floor dysfunction

Red Flags (Need further evaluation)

• GI bleeding, anemia, weight loss, nocturnal symptoms
• Onset after age 50, family history of IBD/colon cancer/celiac
• Fever, persistent vomiting

Diagnosis

• Clinical diagnosis using Rome IV criteria after ruling out alarm features
• Basic labs: CBC, CRP, celiac serology, stool studies if indicated
• Colonoscopy for alarm features or age-appropriate screening
• Breath tests for SIBO or carbohydrate malabsorption in select cases

Treatment & Management

Lifestyle & Diet

• Track symptoms, identify triggers (stress, food, hormones)
• Low FODMAP diet trial under dietitian guidance
• Soluble fiber (psyllium) for IBS-C or IBS-M
• Avoid trigger foods (caffeine, alcohol, artificial sweeteners) if sensitive
• Adequate hydration, regular exercise, sleep hygiene

Medications

• IBS-C: osmotic laxatives, lubiprostone, linaclotide, plecanatide, prucalopride
• IBS-D: loperamide, bile acid sequestrants, rifaximin, eluxadoline
• Pain relief: antispasmodics (dicyclomine), low-dose tricyclics, SSRIs/SNRIs for visceral pain modulation
• Probiotics: certain strains may reduce bloating/pain

Gut-Brain Therapies

• Cognitive behavioral therapy (CBT), gut-directed hypnotherapy
• Mindfulness, yoga, diaphragmatic breathing
• Biofeedback for pelvic floor dysfunction

Complementary Approaches

• Peppermint oil capsules for pain/bloating
• Acupuncture, trigger point therapy
• Stool-based microbiome testing is experimental; interpret cautiously

Living with IBS

• Maintain a symptom diary noting diet, stress, hormones, medications
• Build a flare plan (hydration, safe foods, medications)
• Communicate needs at work/school (restroom access, schedule flexibility)
• Seek mental health support—IBS can be socially isolating
• Address comorbid conditions (migraine, fibromyalgia, anxiety)

Complications

• Reduced quality of life, absenteeism
• Nutritional deficiencies from overly restricted diets
• Higher rates of anxiety/depression

Research & Future Directions

Studies examine microbiome signatures, immune modulation, neuromodulation devices, and precision nutrition using metabolomics.

Experimental & Emerging Treatments

• Microbiome Therapies: Targeted probiotics, synbiotics, and fecal microbiota transplant are being studied to rebalance gut flora.
• Vagus Nerve Stimulation: External devices aim to calm visceral hypersensitivity through the gut-brain axis.
• Histamine & Mast Cell Modulators: Agents like ketotifen or DAO supplements for patients with mast-cell-driven IBS.
• Digital Therapeutics: App-based CBT/hypnotherapy programs deliver structured gut-brain therapy at scale.

Track IBS with Diagnoza.care

Calm Your Gut with Data – Log foods, stress, hormones, bowel movements (Bristol scale), medications, and flares, schedule GI and dietitian visits, capture side effects, and let the AI companion spot trigger patterns you can actually act on.

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Medical Disclaimer: Informational only. Work with your gastroenterologist and dietitian to confirm diagnosis, rule out other conditions, and create a personalized management plan. Sources: American College of Gastroenterology, Rome Foundation, International Foundation for Gastrointestinal Disorders