Irritable bowel syndrome (IBS) is a chronic condition that is characterized by abdominal pain and changes in bowel habits. Up to 20 percent of the US population suffers with IBS, making it the most common GI condition, and it is second only to the common cold as a cause of absence from work. There are three forms, IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), and IBS mixed type – having both diarrhea and constipation. The cause of IBS, despite extensive research, is not entirely clear, but is likely due to a combination of factors. These factors include abnormal contractions of the intestines, hypersensitivity of the bowel to stimulation, certain food intolerances, and abnormal bacteria colonization of the digestive tract. In addition to abdominal pain and bowel habit abnormalities, patients with IBS often complain of abnormal gas, bloating, mucus in the stool, small pebble-like stools, and urgency to move one’s bowels. IBS is a “diagnosis of exclusion,” meaning that there is no single test that identifies a person as having IBS, but rather the IBS diagnosis is reached when patients have appropriate symptoms and tests fail to reveal another diagnosis (like SIBO or celiac sprue or Crohn’s disease, for example). Standard treatments for IBS include fiber supplements, dietary changes, probiotics, antispasmodics, low dose tricyclic antidepressants, anti-diarrheal drugs, gentle laxatives, and a non-absorbable antibiotic. There have been a number of new IBS targeted medications to come out in recent years, such as Lotronex, Linzess, Amitiza, Trulance, Viberzi, and others that have been very effective in many of our IBS patients. Studies have consistently shown that IBS hurts a patient’s quality of life, but does not lead to a shortening of life expectancy.