Diarrhea- and Constipation-predominant Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) has a reputation for being hard to treat, trivial, and often psychologic in origin. Furthermore, there currently appears to be almost more of a stigma attached to being diagnosed as having IBS than a depressive illness. Thus, it is not surprising that patients with this syndrome become distressed by the attitudes they encounter, particularly as we now know that this condition can substantially impair one's quality of life. The problem with effective management is that there is no "standard treatment" and therapy has to be targeted to the symptoms of the individual patient. This frequently proves to be time consuming and also may involve some degree of trial and error. However, when all the issues surrounding IBS are addressed in a sympathetic and positive manner, these patients can be surprisingly rewarding to treat.