Navigating the World of IBS Doctors: What You Need to Know

Medically reviewed by Jay N. Yepuri, MD

Irritable bowel syndrome (IBS) causes gastrointestinal (GI) symptoms like abdominal pain, diarrhea, constipation, and bloating. Getting an accurate, timely diagnosis from a healthcare provider helps minimize the disruptive effects of IBS.

There is no one-size-fits-all IBS treatment. You may need to see various medical experts and experiment with treatments before finding a winning combination.

This article reviews why it’s necessary to see an IBS provider for diagnosis, types of providers who treat IBS, how to find a provider, preparing for your first visit, and common treatments.

Do I Have to See an IBS Provider for Diagnosis?

It is essential to see a healthcare provider for an accurate IBS diagnosis. IBS is complex, and symptoms can overlap with other GI disorders. Self-tests and symptom checklists are available online but are not specific enough to differentiate IBS from other GI conditions. Relying on self-tests can lead to a misdiagnosis and treatment delay.

Understanding IBS Providers

IBS symptoms can disrupt daily activities and work, school, and social events. Getting a timely, accurate diagnosis and treatment from a healthcare provider can minimize these disruptions. Treatment can aid symptom relief, improve mental health, prevent complications, and increase your quality of life.

Types of IBS Medical Providers

IBS care may involve medical providers such as:

• Family medicine providers: Offer comprehensive healthcare for all ages and can diagnose and help you manage IBS and provide referrals to specialists

• Internist: Specializing in adult care, internists can diagnose and manage IBS and consult specialists

• Gastroenterologists: Specialize in diagnosing and managing digestive disorders such as IBS

Mental Health Professionals for IBS Care

Depression and anxiety are common among people with IBS, with nearly one-third of people experiencing a co-occurring mental health challenge. Comprehensive, interdisciplinary care of IBS may include mental health professionals such as:

• Psychiatrists: Medical doctors (M.D.s) who specialize in mental health and can prescribe medications

• Behavioral therapists: Specialize in modifying behaviors and developing coping strategies using techniques like cognitive-behavioral therapy (CBT)

• Psychotherapists: Provide talk therapy to address possible emotional and psychological factors

• Psychologists: Specialize in understanding behavior and mental processes and offering strategies to alleviate stress, anxiety, or depression

Dietitians and Nutritionists for IBS

Dietitians and nutritionists provide dietary guidance to alleviate IBS symptoms and improve digestive health. They can help identify trigger foods and recommend IBS-specific dietary plans with optimal nutritional benefits.

Physical Therapists and IBS

The dysfunction of the pelvic floor (muscles that support the intestines) may cause or worsen IBS. Some physical therapists specialize in pelvic floor therapy, which involves exercises and techniques to help alleviate pelvic floor dysfunction.

Alternative Providers for IBS

Complementary care might involve the following providers:

• Massage therapists: Provide hands-on manipulation of soft tissues to alleviate muscle tension

• Herbalists: Use medicinal plants to help alleviate IBS symptoms

• Acupuncturists: Insert thin needles into specific points on the body to reduce IBS symptoms

When to Contact an IBS Provider

Contact an IBS provider if you experience periods of abdominal pain, constipation, diarrhea, or bloating that lasts several weeks. People with a uterus may notice that symptoms worsen before or during their period.

How to Find an IBS Provider

The following steps can help you identify an IBS provider who aligns with your preferences and circumstances.

• Recommendations: Ask for recommendations from your primary care provider.

• Research gastroenterologists: Look for providers with board certifications and experience treating IBS.

• Location, availability, and insurance: Choose a provider with a convenient location. Check their availability and if they (and the facility where they perform procedures) accept your insurance plan.

• Read patient reviews: Patient reviews provide insights about the provider's communication style and patient experience in their clinic.

• Consult multiple providers: Schedule consultations with more than one provider to determine which provider makes you feel comfortable and confident.

How to Prepare for Your First Visit to an IBS Provider

Before your first visit with an IBS provider, make notes about your symptoms. Include details about how long they last, their severity, and factors that make them better or worse. The provider may perform a physical exam and order diagnostic tests such as:

• Blood tests

• Stool studies

• Imaging

• Colonoscopy

Related: How Do You Know If You Have IBS? (Diagnosis Steps)

Common Treatment Options for IBS

If a healthcare provider diagnoses you with IBS, they may recommend lifestyle changes or over-the-counter (OTC) or prescription medications. Some people use alternative therapies to relieve their IBS symptoms.

Lifestyle Changes and Self-Care

Consider the following lifestyle changes and self-care strategies to manage IBS:

• Drink plenty of water.

• Get adequate sleep.

• Get regular physical activity.

• Manage stress.

• Perform self-abdominal massages.

• Slowly increase soluble fiber (and avoid insoluble fiber in your diet).

• Sip warm herbal tea (peppermint, anise, chamomile, turmeric, or ginger).

• Trial a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, polyols) diet.

• Use a food diary to identify and avoid trigger foods.

• Use heat therapy (hot water bottle, heating pad, or warm bath).

Medication for IBS

Medication treatment options for IBS depend on which IBS subtype you have.

IBS Subtypes

IBS is categorized into the following subtypes based on your symptoms:

• IBS-D (diarrhea)

• IBS-C (constipation)

• IBS-M (mixed diarrhea and constipation)

• IBS-U (unidentified bowel pattern)

Temporary diarrhea relief might include over-the-counter (OTC) antidiarrheals such as:

• Imodium (loperamide)

• Pepto-Bismol, Kaopectate (bismuth subsalicylate) (can temporarily make your tongue or stool turn dark or black)

OTC medications for constipation relief may include:

• Dulcolax (bisacodyl) or glycerin suppositories (bullet-shaped medicines that go into the rectum, the last part of the intestines)

• Enemas (liquid that goes into the rectum) for severe constipation

• Metamucil (psyllium fiber)

• Milk of Magnesia (magnesium hydroxide)

• Miralax (polyethylene glycol 3350)

• Soluble fiber supplements for constipation

Providers commonly prescribe the following medications for IBS:

• Bentyl (dicyclomine) or Levsin (hyoscyamine) for cramping

• Elavil (amitriptyline) or Zoloft (sertraline) for underlying depression

• Linzess, Constella (linaclotide), Amitiza (lubiprostone), Trulance (plecanatide), Motegrity (prucalopride), or Zelnorm (tegaserod) for constipation

• Lotronex (alosetron) or Viberzi (eluxadoline) for diarrhea

• Xifaxan (rifaximin), an antibiotic that treats bacterial overgrowth in the small intestines 
  

Alternative Therapies

Alternative therapies and complementary approaches might include:

• Acupuncture

• Acupressure

• Hypnotherapy

• Massage

• Natural remedies like peppermint oil or ginger
  

• Probiotics

Related: How IBS Is Treated

Building a Strong Provider-Patient Relationship

Building a strong provider-patient relationship involves open communication on both sides. It helps to find a provider who listens and includes you in decision-making. Try to be open and honest about your symptoms and complementary therapies you are considering. Ask questions to seek clarification.

What to Do When IBS Becomes Severe

Schedule an appointment with a healthcare provider if your symptoms become severe. Don’t be shy about discussing the impact on your daily life. Sometimes, they may recommend further testing, medication changes, or a gastroenterology consultation.

When to Seek Emergency Medical Care

Signs you should seek emergency care for stomach cramps include:

• Fever (100.4 degrees F or higher)

• Large amounts of rectal bleeding or blood in your stool

• Severe and persistent abdominal pain that doesn’t resolve with treatment

• Persistent and severe diarrhea or vomiting

• Severe dehydration (dizziness, rapid heartbeat, dark urine)
  

Summary

IBS is a complex condition with symptoms that overlap with other gastrointestinal disorders. It is necessary to see an IBS healthcare provider for an accurate diagnosis and treatment. Taking proactive steps to manage IBS can improve your quality of life. Find a provider who understands IBS, makes you feel comfortable, includes you in decision-making, and considers an interdisciplinary approach. 

Read the original article on Verywell Health.