{"id":747,"date":"2026-03-11T07:17:25","date_gmt":"2026-03-11T07:17:25","guid":{"rendered":"https:\/\/naturalherbmedicine.com\/?p=747"},"modified":"2026-03-11T08:19:18","modified_gmt":"2026-03-11T08:19:18","slug":"irritable-bowel-syndrome-ibs-2","status":"publish","type":"post","link":"https:\/\/naturalherbmedicine.com\/index.php\/irritable-bowel-syndrome-ibs-2\/","title":{"rendered":"IRRITABLE BOWEL SYNDROME &#8211; IBS"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">EARLIEST DESCRIPTIONS OF SYMPTOMS DEFINING IBS<br><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>1849 \u2013 W Cumming<sup>1<\/sup><\/strong>\u201cThe bowels are at one time constipated,at another lax, in the same person. How the disease has two such different symptoms I do not profess to explain. . . .\u201d<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Other historical terms<\/strong> \u2013 mucous colitis \u2013 colonic spasm \u2013 neurogenic mucous colitis \u2013 irritable colon \u2013 unstable colon \u2013 nervous colon \u2013 spastic colon \u2013 nervous colitis \u2013 spastic colitis1962 \u2013 Chaudhary &amp; Truelove2\u00a0 Irritable colon syndrome1966 \u2013 CJ DeLor3 Irritable bowel syndrome<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">HISTORICAL PERSPECTIVE<br><\/h2>\n\n\n\n<p>sufferers are women)<sup>2<\/sup>\u2013 \u00a0 condition not fatal<\/p>\n\n\n\n<p>\u2022Long dismissed as a psychosomatic condition<sup>1<\/sup> no clear etiology\u2013 \u00a0 affects predominantly women(~70% of <\/p>\n\n\n\n<p>\u2022Attitudes now changing<\/p>\n\n\n\n<p>\u2022Incidence and prevalence not extensively monitored in past<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">HALLMARK SYMPTOMS OF IBS<br><br><\/h2>\n\n\n\n<p>\u2022Chronic or recurrent GI symptoms\u2013 \u00a0 lower abdominal pain\/discomfort\u2013 \u00a0 altered bowel function (urgency,altered stool consistency, altered stool frequency, incomplete evacuation)\u2013 \u00a0 bloating<\/p>\n\n\n\n<p>\u2022Not explained by identifiable structural or<br>biochemical abnormalities<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">KEY FACTS ABOUT IBS<br><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Up to 20% of the US population report symptoms consistent with IBS<sup>1<\/sup><\/li>\n\n\n\n<li>The most common GI diagnosis among\u00a0gastroenterology practices in the US<sup>2<\/sup><\/li>\n\n\n\n<li>One of the top 10 reasons for PCP visits<sup>3<\/sup><\/li>\n\n\n\n<li>Affects predominantly females (~70% of sufferers)<sup>4<\/sup><\/li>\n\n\n\n<li>The most common functional bowel disorder<sup>5<\/sup><\/li>\n\n\n\n<li>Can cause great discomfort, sometimes intermittent or continuous, for many decades in a patient\u2019s life<sup>1<\/sup><\/li>\n\n\n\n<li>Can significantly disrupt daily life<sup>2<\/sup><\/li>\n\n\n\n<li>Can have negative impact on quality of life<sup>2<\/sup><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Current treatment options\u2013 dietary modification\u2013 fiber supplements\u2013 pharmacologic agents\u2013 psychotherapy<\/li>\n\n\n\n<li>Success of current treatment options in addressing multiple symptoms of IBS has been limited<sup>4<\/sup><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">iBS Consultation pattern<br><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"728\" height=\"470\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/pyramid_no_border-1.png\" alt=\"\" class=\"wp-image-752\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/pyramid_no_border-1.png 728w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/pyramid_no_border-1-300x194.png 300w\" sizes=\"(max-width: 728px) 100vw, 728px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">DIRECT MEDICAL COSTS ASSOCIATED WITH IBS<br><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>BS results in an estimated $8 billion in direct medical costs annually<sup>1<\/sup><\/li>\n\n\n\n<li>IBS sufferers incur 74% more direct healthcare costs than non-IBS sufferers<sup>1<\/sup><\/li>\n\n\n\n<li>IBS patients have more physician visits for both GI and non-GI complaints<sup>2<\/sup><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">PRODUCTIVITY BURDEN<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"496\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/absenteeism_chart-1024x496.jpg\" alt=\"\" class=\"wp-image-753\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/absenteeism_chart-1024x496.jpg 1024w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/absenteeism_chart-300x145.jpg 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/absenteeism_chart-768x372.jpg 768w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/absenteeism_chart.jpg 1067w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Impact on work due to IBS<br><\/h2>\n\n\n\n<p>Patients with some missed workdays \u2014 30%<br>Average number missed workdays* \u2014 1.7<br>Patients who cut back some days \u2014 46%<br>Average number days cut back* \u2014 3<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">EVOLUTION OF MECHANISTIC HYPOTHESES IN IBS<br><\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"389\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/b1f0a37d-f549-4ba6-aad9-42ec0a633cdc-1024x389.png\" alt=\"\" class=\"wp-image-754\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/b1f0a37d-f549-4ba6-aad9-42ec0a633cdc-1024x389.png 1024w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/b1f0a37d-f549-4ba6-aad9-42ec0a633cdc-300x114.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/b1f0a37d-f549-4ba6-aad9-42ec0a633cdc-768x292.png 768w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/b1f0a37d-f549-4ba6-aad9-42ec0a633cdc.png 1136w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">IRRITABLE BOWEL SYNDROME<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Biopsychosocial Disorder\u2013Psychosocial\u2013Motility\u2013Sensory\u2013? Infectious<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Prevalence 10%, Incidence 1-2% per Year<\/li>\n\n\n\n<li>Disturbs QOL, Social Function, Healthcare Utilization<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"612\" height=\"377\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/40639eaf-13e8-4032-9902-b38a598b3fac.png\" alt=\"\" class=\"wp-image-755\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/40639eaf-13e8-4032-9902-b38a598b3fac.png 612w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/40639eaf-13e8-4032-9902-b38a598b3fac-300x185.png 300w\" sizes=\"(max-width: 612px) 100vw, 612px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">ENTERIC NERVOUS SYSTEM<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Controls motility and secretory functions of the intestine<\/li>\n\n\n\n<li>Semiautonomous\u2013\u00a0 actions modified by parasympathetic and sympathetic nervous systems\u2013\u00a0 may function independently<\/li>\n\n\n\n<li>Contains many neurotransmitters, including 5-HT, substance P, VIP (vasoactive intestinal peptide), and CGRP (calcitonin gene-related peptide)<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">IBS: Current thinking on pathophysiology<\/h2>\n\n\n\n<p>Defects in the enteric nervous system may leadto the hallmark symptoms of IBS<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Visceral hypersensitivity1 <\/strong>\u2013\u00a0 Increased visceral afferent response to normal as well as noxious stimuli\u2013\u00a0 Mediators include 5-HT, bradykinin, tachykinins, CGRP, and neurotropins<\/li>\n\n\n\n<li>Primary motility disorder of GI tract<sup>2<\/sup> \u00a0 \u2013\u00a0 Mediated by 5-HT, acetylcholine, ATP, motilin, nitric oxide, somatostatin, \u00a0 substance P, and VIP<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">PHYSIOLOGICAL DISTRIBUTION OF 5-HT<\/h2>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"986\" height=\"450\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/5d9210c7-e22d-49c3-9db3-d4c02c5794f0.png\" alt=\"\" class=\"wp-image-758\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/5d9210c7-e22d-49c3-9db3-d4c02c5794f0.png 986w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/5d9210c7-e22d-49c3-9db3-d4c02c5794f0-300x137.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/5d9210c7-e22d-49c3-9db3-d4c02c5794f0-768x351.png 768w\" sizes=\"(max-width: 986px) 100vw, 986px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">5-HT initiates peristaltic reflex mediated by the ENS<\/h2>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"872\" height=\"506\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/8fcc64d3-e30b-4a72-893c-cb26c11c97f3.png\" alt=\"\" class=\"wp-image-759\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/8fcc64d3-e30b-4a72-893c-cb26c11c97f3.png 872w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/8fcc64d3-e30b-4a72-893c-cb26c11c97f3-300x174.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/8fcc64d3-e30b-4a72-893c-cb26c11c97f3-768x446.png 768w\" sizes=\"(max-width: 872px) 100vw, 872px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">5-HT<sub> <\/sub>RECEPTOR EFFECTS<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u2022Mediate reflexes controlling gastrointestinal motility and secretion<\/li>\n\n\n\n<li>Mediate perception of visceral pain<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">COMPARISON OF PAIN THRESHOLDS OF IBS PATIENTS AND CONTROLS<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"504\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/31920b5c-beb2-4d89-a593-bc43a3a174db-1024x504.png\" alt=\"\" class=\"wp-image-760\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/31920b5c-beb2-4d89-a593-bc43a3a174db-1024x504.png 1024w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/31920b5c-beb2-4d89-a593-bc43a3a174db-300x148.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/31920b5c-beb2-4d89-a593-bc43a3a174db-768x378.png 768w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/31920b5c-beb2-4d89-a593-bc43a3a174db.png 1080w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">COMPARISON OF PAIN THRESHOLDS<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"397\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/fb862c73-b0a7-4ba1-b976-55c9bbb8eb3a-1024x397.png\" alt=\"\" class=\"wp-image-761\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/fb862c73-b0a7-4ba1-b976-55c9bbb8eb3a-1024x397.png 1024w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/fb862c73-b0a7-4ba1-b976-55c9bbb8eb3a-300x116.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/fb862c73-b0a7-4ba1-b976-55c9bbb8eb3a-768x297.png 768w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/fb862c73-b0a7-4ba1-b976-55c9bbb8eb3a.png 1162w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">MAKE A POSITIVE DIAGNOSIS<sup>1,2<\/sup><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"1006\" height=\"507\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/f6a7cfcc-f76f-4e2b-9a6b-143818657745.png\" alt=\"\" class=\"wp-image-762\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/f6a7cfcc-f76f-4e2b-9a6b-143818657745.png 1006w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/f6a7cfcc-f76f-4e2b-9a6b-143818657745-300x151.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/f6a7cfcc-f76f-4e2b-9a6b-143818657745-768x387.png 768w\" sizes=\"(max-width: 1006px) 100vw, 1006px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">HISTORY OF DIAGNOSTIC APPROACHES<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>1950s \u2013 Increased gut motility<sup>1<\/sup><\/li>\n\n\n\n<li>1970s \u2013 Specific motility markers<sup>1<\/sup><\/li>\n\n\n\n<li>1980 to 1999 \u2013 Symptom-based criteria<sup>1<\/sup>\u2013Manning criteria\u2013Rome criteria<\/li>\n\n\n\n<li>1999 \u2013 Rome II criteria<sup>2<\/sup><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">IBS ROME II CRITERIA<\/h2>\n\n\n\n<p>At Least 12 Weeks, Which Need Not Be Consecutive, in the Preceding 12 Months, of Abdominal Discomfort or Pain That Has Two of Three Features:<\/p>\n\n\n\n<p>1.Relieved with Defecation; and\/or<\/p>\n\n\n\n<p>2. Onset Associated with a Change in Frequency of Stool; and\/or <\/p>\n\n\n\n<p>3. Onset Associated with a Change in Form (Appearance) of Stool<br><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"461\" height=\"232\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/b4557294-0b69-453b-9f4d-d6314835d56b.png\" alt=\"\" class=\"wp-image-763\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/b4557294-0b69-453b-9f4d-d6314835d56b.png 461w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/b4557294-0b69-453b-9f4d-d6314835d56b-300x151.png 300w\" sizes=\"(max-width: 461px) 100vw, 461px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">RED FLAGS\u201d MAY SUGGEST AN ALTERNATIVE OR COEXISTING DIAGNOSIS<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"66\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/image-1024x66.png\" alt=\"\" class=\"wp-image-764\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/image-1024x66.png 1024w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/image-300x19.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/image-768x49.png 768w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/image-1536x99.png 1536w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/image.png 1847w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"400\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/9c7adfce-20e2-4199-bdd0-15aa92387732-1024x400.png\" alt=\"\" class=\"wp-image-765\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/9c7adfce-20e2-4199-bdd0-15aa92387732-1024x400.png 1024w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/9c7adfce-20e2-4199-bdd0-15aa92387732-300x117.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/9c7adfce-20e2-4199-bdd0-15aa92387732-768x300.png 768w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/9c7adfce-20e2-4199-bdd0-15aa92387732.png 1038w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">DIAGNOSTIC TESTS\u2014WHAT? WHEN? WHO?<\/h2>\n\n\n\n<p>If patient has typical features of IBS:<\/p>\n\n\n\n<p>\u2022If &lt;50 years of age, order CBC, electrolytes, LFTs, screen stool for occult blood, and consider sigmoidoscopy.<sup>1<\/sup><\/p>\n\n\n\n<p>\u2022If \u00b350 years of age, order CBC, electrolytes, LFTs, and perform a colonoscopy or air-contrast barium enema with sigmoidoscopy.<sup>1,2<\/sup><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">DIFFERENTIAL DIAGNOSIS<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Malabsorption<sup>1<\/sup><\/li>\n\n\n\n<li>Dietary factors<sup>1<\/sup><\/li>\n\n\n\n<li>Infection<sup>1<\/sup><\/li>\n\n\n\n<li>Inflammatory bowel disease<sup>1<\/sup><\/li>\n\n\n\n<li>Psychological disorders<sup>1<\/sup><\/li>\n\n\n\n<li>Gynecological disorders<sup>2<\/sup><\/li>\n\n\n\n<li>Miscellaneous<sup>1<\/sup><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">CURRENT MANAGEMENT OF IBS<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Establish a positive diagnosis<sup>1<\/sup><\/li>\n\n\n\n<li>Reassure patient that there is no serious<br>organic disease or alarming symptoms<sup>1<\/sup><\/li>\n\n\n\n<li>Success of current treatment options in addressing multiple symptoms of IBS has been limited<sup>2<\/sup><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">CURRENT MANAGEMENT COMPONENTS OF IBS<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Education<\/li>\n\n\n\n<li>Reassurance\u2022Dietary modification<\/li>\n\n\n\n<li>Fiber<\/li>\n\n\n\n<li>Symptomatic treatment<\/li>\n\n\n\n<li>Psychological\/behavioral options<\/li>\n\n\n\n<li>Realistic goals<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Laxatives and bulking agents<\/h2>\n\n\n\n<p>Symptomatic treatment\u2014constipation<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Increased dietary fiber or psyllium<sup>1<\/sup><\/li>\n\n\n\n<li>Osmotic laxatives (MgSO<sub>4<\/sub>, lactulose)<sup>2<\/sup><\/li>\n\n\n\n<li>Stimulant laxatives<sup>3<\/sup><\/li>\n\n\n\n<li>Some laxatives and bulking agents can exacerbate abdominal pain and bloating<sup>3<\/sup><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">TRICYCLIC ANTIDEPRESSANTS AND SSRIS<\/h2>\n\n\n\n<p>Symptomatic treatment\u2014pain<\/p>\n\n\n\n<p>\u2022Reserved for patients with severe or refractory pain<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Multiple medications needed to treat multiple symptoms<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"393\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/4a3d3534-b331-48d1-bf66-af73c4c3298a-1024x393.png\" alt=\"\" class=\"wp-image-769\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/4a3d3534-b331-48d1-bf66-af73c4c3298a-1024x393.png 1024w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/4a3d3534-b331-48d1-bf66-af73c4c3298a-300x115.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/4a3d3534-b331-48d1-bf66-af73c4c3298a-768x295.png 768w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/4a3d3534-b331-48d1-bf66-af73c4c3298a.png 1096w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">A COMPREHENSIVE MULTICOMPONENT APPROACH<\/h2>\n\n\n\n<p>Treatment program is based on dominant symptoms and their severity and on psychosocial factors<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Medical management<\/li>\n\n\n\n<li> Diet<\/li>\n\n\n\n<li> Psychological or behavioral options\u2013 psychotherapy\u2013 stress management<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">INITIAL MANAGEMENT OF IBS<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"480\" src=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/2813a030-2717-4c48-9708-57b892ed01d3-1024x480.png\" alt=\"\" class=\"wp-image-770\" srcset=\"https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/2813a030-2717-4c48-9708-57b892ed01d3-1024x480.png 1024w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/2813a030-2717-4c48-9708-57b892ed01d3-300x140.png 300w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/2813a030-2717-4c48-9708-57b892ed01d3-768x360.png 768w, https:\/\/naturalherbmedicine.com\/wp-content\/uploads\/2026\/03\/2813a030-2717-4c48-9708-57b892ed01d3.png 1072w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Non-Traditional Remedies<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Chinese Herbal Medicine \u2013116 pts randomized to CHM did better than pts receiving placebo<\/li>\n\n\n\n<li>Peppermint Oil\u2013Relaxation of GI smooth muscle\u2013Meta-analysis showed significant improvement of IBS symptoms<\/li>\n\n\n\n<li>Acupunture<\/li>\n\n\n\n<li>Probiotics<\/li>\n\n\n\n<li>Antibiotics<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Surgical Therapy for IBS<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>IBS symptoms may be attributed to:\u2013Non-functioning gallbladder disease, chronic appendicitis, uterine fibroids, tortuous colon<\/li>\n\n\n\n<li>IBS symptoms rarely improve after surgery<\/li>\n\n\n\n<li>IBS patients 2 to 3 times more likely to undergo unnecessary surgery<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Take Home Points<\/h2>\n\n\n\n<p>\u2022IBS is a chronic medical condition characterized by abdominal pain, diarrhea or constipation, bloating, passage of mucus and feelings of incomplete evacuation<\/p>\n\n\n\n<p>\u2022Precise etiology of IBS is unknown and therefore treatment is focused on relieving symptoms rather that \u201ccuring disease\u201d<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Take Home Points<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Although many IBS patients complain of symptoms after eating, true food allergies are uncommon<\/li>\n\n\n\n<li>Specific therapies are determined by individual patient symptoms<\/li>\n\n\n\n<li>Life-style modifications and possible alternative therapies may relieve symptoms<\/li>\n\n\n\n<li>Surgery has NO Role in treatment of IBS<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>EARLIEST DESCRIPTIONS OF SYMPTOMS DEFINING IBS HISTORICAL PERSPECTIVE sufferers are women)2\u2013 \u00a0 condition not fatal \u2022Long dismissed as a psychosomatic condition1 no clear etiology\u2013 \u00a0 affects predominantly women(~70% of \u2022Attitudes now changing \u2022Incidence and prevalence not extensively monitored in past HALLMARK SYMPTOMS OF IBS \u2022Chronic or recurrent GI symptoms\u2013 \u00a0 lower abdominal pain\/discomfort\u2013 \u00a0 altered [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":771,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-747","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/posts\/747","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/comments?post=747"}],"version-history":[{"count":3,"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/posts\/747\/revisions"}],"predecessor-version":[{"id":772,"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/posts\/747\/revisions\/772"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/media\/771"}],"wp:attachment":[{"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/media?parent=747"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/categories?post=747"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naturalherbmedicine.com\/index.php\/wp-json\/wp\/v2\/tags?post=747"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}