Irritable Bowel Syndrome (IBS)
What Is It?
Functional GI disorder with recurrent abdominal pain related to bowel habits (constipation, diarrhea, or both) without structural or biochemical abnormality.
How Is It Diagnosed?
Rome IV criteria: abdominal pain 1 or more days per week for 3 months with at least 2 of: related to defecation, change in stool frequency, change in stool form. Rule out IBD, celiac, infection.
How Is It Treated?
IBS-D: loperamide, rifaximin, eluxadoline, low-FODMAP diet. IBS-C: fiber, polyethylene glycol, linaclotide, lubiprostone. Antispasmodics, low-dose TCAs for pain. Gut-directed psychotherapy.
Tests and Imaging Typically Needed
CBC, CMP, CRP, ESR, celiac panel (tTG-IgA), stool calprotectin, fecal occult blood. Colonoscopy if alarm features.
Approximate Self-Pay Costs
Office visit: $95-$150. Lab panel: $80-$130. Medications: $10-$300/month depending on agent.