IBS in Primary Care: A Practical Approach to Diagnosis and Management

In this episode, Dr. Ari Garber joins us to discuss a practical, primary care–focused approach to irritable bowel syndrome. Through case-based discussion, we review the diagnosis and subtypes of IBS, appropriate initial evaluation, alarm features that warrant further testing or GI referral, and the shift toward a positive diagnostic strategy rather than a diagnosis of exclusion. We also discuss management of IBS-D and IBS-C, including dietary strategies, neuromodulators, antidiarrheals, constipation-directed therapies, pelvic floor dysfunction, GLP-1–related GI side effects, probiotics, gut-directed psychotherapy, and the role of multidisciplinary care.