Most people can be diagnosed with IBS through symptoms and simple blood test however patient with alarm features (older patient >45, blood in stools, unintended weight loss, fever, anemia, family history of colorectal cancer etc) may need more invasive investigation like endoscopy. For patient with mild IBS symptoms can normally be controlled by various combination of antispasmodic, laxative, prokinetic or antidiarrheal depending on the symptoms.
Dietary modification, a diet low in fermentable oligo-, di- and monosaccharides and polyols (FODMAPs) and exclusion of gas-producing foods (eg beans, onions, carrots, prunes) usually help. Patient often benefit from probiotic agents too. However, for moderate to severe IBS symptoms, low-dose antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitor may be effective in the treatment of IBS, even in patients without concomitant psychiatric diagnoses.
IBS patients with co-morbid anxiety and depression will also benefit from adequate treatment of co-morbid psychological disorders including relaxation and exercise. It is also important to avoid food or stressful event that may trigger IBS. Getting a good night’s sleep is utmost important.