What is IBS?

Irritable bowel syndrome, or IBS, is described by the International Foundation for Functional Gastrointestinal Disorders as a functional GI disorder in which abdominal pain or discomfort occurs along with a range of symptoms that do not arise from another disease.

Generally speaking, IBS is some constellation of abdominal pain, bloating, diarrhea and constipation. Patients with IBS may suffer from one or a combination of these symptoms.

There are 3 types of IBS. They include:


IBS with constipation is often referred to as IBS-C or constipation-predominant IBS.
Constipation is a common symptom of those having IBS. The medical definition of constipation is if you have less than 3 bowel movements a week or difficulty having a bowel movement.


IBS that causes diarrhea is referred to as IBS-D or diarrhea-predominant IBS. Those with IBS-D have belly pain and diarrhea (loose, frequent bowel movements) as their main symptoms. The stool is often described as loose and those with IBS-D often experience sudden urges to use the restroom.


Some IBS patients suffer from both diarrhea and constipation – this is referred to as mixed IBS.

IBS Symptoms

The main symptom of IBS is abdominal pain and it’s estimated that 70% of those with IBS symptoms never consult their doctor. IBS symptoms can occur infrequently or on a regular basis.

The most common IBS symptoms include:

When to see a Doctor for IBS Symptoms?

Because the symptoms of IBS can be seen with other diseases, including Celiac Disease, Crohn’s Disease, Ulcerative Colitis and Colon Cancer, it’s important for people who experience these symptoms more often and more frequently to seek evaluation by a physician.

For those people in the Fort Worth, TX area experiencing any of the above IBS symptoms, you should see a GI doctor to be properly evaluated. Dr. Yepuri recommends keeping a diary of your symptoms and note changes in diet, exercise, stress or medications. This information will help your doctor with their diagnosis.

Causes of IBS

The precise cause of IBS is unknown. However, there are several factors that appear to contribute to IBS. These include:

  • A disturbance in the way the brain and the gut interact
  • A change in the bacterial flora (population) of the GI tract
  • Altered motility (movement) of the intestines
  • Inflammation of the intestines
  • Abnormalities of the intestinal nervous system

Diagnosis of IBS

The current diagnostic criteria used by gastroenterologists for Irritable Bowel Syndrome is called the Rome IV Diagnostic Criteria. The U.S. National Institutes of Health summarizes the Rome IV IBS diagnostic criteria as recurrent abdominal pain, on average, at least 1 day per week in the last 3 months associated with 2 or more of the following:

  • Defecation (having a bowel movement)
  • A change in stool frequency
  • A change in stool form or appearance

In more general terms… you need to have pain that might be relieved with defecation along with a change in stool pattern for 3 months or longer.

However, the actual process of making a diagnosis depends on a careful physical exam and a detailed medical history provided to a gastroenterologist. Dr. Yepuri takes the time to sit and talk with his patients, taking a careful, detailed medical history in order to reach a proper diagnosis and develop an individualized plan for treatment.

Tests for IBS

In addition to the physical exam and medical history, your gastroenterologist may want to conduct other tests and procedures to ensure the correct diagnosis is made. These tests may include:

  • Blood tests – to check the liver, kidneys, pancreas and other blood counts.
  • Endoscopy (EGD) – an upper endoscopy will allow your doctor to rule out conditions like Celiac Disease.
  • Breath Testing – to look for things like lactose intolerance, fructose malabsorption and bacterial overgrowth (SIBO).
  • Colonoscopy – to rule out diseases like Ulcerative Colitis, Crohn’s Disease, Microscopic Colitis and Colon Cancer.

IBS Treatment

Treatments for IBS are patient specific and aimed at targeting a patient’s main symptoms. There are several options your gastroenterologist has available for treatment. Dr. Yepuri describes IBS treatment options in 3 categories:

  • Diet – Food sensitivities often trigger IBS symptoms, so it is important to document your diet and explain any reactions to certain foods to your doctor. Since the influence of diet can vary, there are not generalized dietary recommendations. It’s important to work with your doctor or a registered dietician before making dietary changes to limit symptoms.
  • Medications – To ease abdominal pain, antispasmodics are often prescribed to IBS patients. Also, GI specific antibiotics may used to treat bacterial overgrowth if that is suspected of causing symptoms. Over the counter and prescription agents are also available to treat diarrhea and constipation.
  • Natural Remedies – There are several natural supplements that can help with promoting a healthy and balanced gut bacterial environment. Speak to your doctor before trying any supplements so they can go over any possible risks along with potential benefits.