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. 2021 Feb 4;56(3):193–217. doi: 10.1007/s00535-020-01746-z

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© The Author(s) 2020

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 2 — Step 1 of the IBS Therapeutic Algorithm. Subtyping of IBS is necessary at the time of treatment. Based on the Rome IV criteria, patients are classified as IBS with predominant diarrhea (IBS-D), IBS with mixed bowel habits (IBS-M), IBS unclassified (IBS-U), or IBS with predominant constipation (IBS-C). Moreover, the most bothersome symptoms including diarrhea, abdominal pain, or constipation may be targeted. See the main text for further details