Fig. 3.

Treatment options for IBS according to predominant symptoms and their severity. Doctor–patient relationship and lifestyle modifications are the mainstay of treatment regardless of symptom severity and probably sufficient in the management of mild symptoms. For moderate symptoms, pharmacological therapies may be added and aim to relief predominant bowel habits and visceral pain. For severe symptoms and patients with refractory symptoms, psychopharmacologic agents and psychotherapy can be used. IBS, irritable bowel syndrome; FODMAP, fermentable oligosaccharides, disaccharides, monosaccharides and polyols; IBS-C, irritable bowel syndrome with predominant constipation; IBS-D, irritable bowel syndrome with predominant diarrhoea; IBS-M, irritable bowel syndrome with predominant irregular bowel habits (mixed C/D).