Quick Answer
Irritable Bowel Syndrome (IBS) is a chronic gut–brain disorder that causes abdominal pain along with diarrhoea, constipation or alternating bowel habits, but no structural disease. Dr. Anando Sengupta manages IBS with a stepwise plan: rule out IBD/celiac/infection, identify dietary triggers (often via a supervised low-FODMAP trial), and use targeted medication and gut–brain therapies. Most patients see substantial improvement within 4–6 weeks.
What is IBS?
IBS is the most common functional disorder of the gut. The bowel looks completely normal on endoscopy and biopsy — the problem lies in how the gut nerves, gut microbes and brain communicate. As a result, the bowel becomes hypersensitive (mild stimuli cause intense cramps) and dysmotile (it moves too fast or too slow).
The three IBS subtypes
| Subtype | Bowel pattern | Typical complaint |
|---|---|---|
| IBS-D | Diarrhoea-predominant | Loose/watery stools, urgency, sometimes mucus |
| IBS-C | Constipation-predominant | Hard or lumpy stools, straining, incomplete evacuation |
| IBS-M | Mixed | Alternating diarrhoea and constipation |
Symptoms
- Recurrent abdominal pain or cramping, usually relieved by passing stool
- Bloating, distension, excessive flatulence
- Mucus in stool (no blood)
- Urgency, sense of incomplete evacuation
- Symptoms triggered by stress, certain foods, or menstrual cycle
Diagnosis
IBS is diagnosed clinically using the Rome IV criteria: recurrent abdominal pain at least one day per week in the last 3 months, related to defecation and/or change in stool form/frequency. Basic blood tests, stool tests (calprotectin), thyroid and celiac screening rule out other causes. Colonoscopy is reserved for patients with alarm features or above age 45.
Treatment options
1. Diet — the foundation
- Low-FODMAP diet — supervised 4–6 week elimination, then structured re-introduction. 60–70% Indian patients respond.
- Adequate soluble fibre (psyllium / isabgol) for IBS-C
- Identify personal triggers — often dairy, wheat, onions, garlic, beans, sugar-free gum
- Smaller, regular meals; adequate hydration; reduce caffeine and alcohol
2. Targeted medication
- Antispasmodics — mebeverine, hyoscine, dicyclomine (relieve cramps)
- Loperamide — on-demand for IBS-D
- Osmotic laxatives — PEG / lactulose for IBS-C
- Rifaximin — non-absorbed antibiotic with proven benefit in IBS-D
- Probiotics — selected Bifidobacterium and Lactobacillus strains
- Linaclotide / lubiprostone / prucalopride for refractory IBS-C
- Low-dose tricyclic antidepressants — for visceral pain modulation, not because IBS is "in your head"
3. Gut–brain therapies
Cognitive behavioural therapy (CBT), gut-directed hypnotherapy and mindfulness-based stress reduction have strong evidence in IBS. They are not a substitute for medical care — they are an addition.
Why patients choose Dr. Sengupta for IBS
- Structured, evidence-based protocol that doesn't dismiss IBS as "just stress"
- Same-day exclusion of red-flag conditions (CBC, CRP, calprotectin, celiac panel, thyroid)
- Practical Indian low-FODMAP guidance with vegetarian options
- Long-term follow-up via teleconsult to fine-tune therapy
