Irritable Bowel Syndrome — The Gut That Looks Normal but Isn’t
The colonoscopy is clear. The biopsy is clean. The CT is unremarkable. And yet the patient is genuinely unwell — month after month. Welcome to IBS: the disorder where the problem is not in the gut, but in how the gut and the brain talk to each other.
Why This Pearl Exists
Every GP in India sees this patient. A young adult, under 45, with months of bloating, alternating diarrhoea and constipation, post-prandial pain, and complete normal investigations. The labs are negative. The endoscopy is normal. The family doubts the diagnosis exists. And yet the symptoms are real — and they are ruining the patient’s life.
This pearl walks you through the full framework: the Rome IV criteria (which every postgraduate exam asks about), how to distinguish IBS from inflammatory bowel disease using faecal calprotectin, the dysbiosis hypothesis that explains everything, and the layered treatment approach — from low-FODMAP diet through linaclotide, rifaximin, SSRIs, and the humble probiotic lassi.
Your Clinical Pearl
Scroll through the note below. Watermarked for content protection.
One Lesson a Day. Every Day.
This Is How Clinical Thinking Is Built.
A fresh clinical insight that stays with you for your entire career. Gastroenterology, cardiology, pharmacology, infectious diseases, musculoskeletal — 16 specialties, one pearl at a time.
Browse All Clinical Pearls →