IBS (Irritable Bowel Syndrome) Treatment in Bathinda — Dr. Raman Garg

If you suffer from recurring abdominal cramps, bloating, unpredictable diarrhoea, or chronic constipation, you may have Irritable Bowel Syndrome (IBS) — one of the most common functional digestive disorders. Dr. Raman Garg at Bombay Gastro & Cancer Institute, Bathinda — the leading gastroenterologist in South Punjab — provides comprehensive, evidence-based IBS treatment that delivers real, lasting relief.

IBS affects approximately 10–15% of the Indian population and is more common in women and young adults. Despite causing significant distress, IBS is often misdiagnosed or undertreated. Many patients spend years taking antispasmodics and antidiarrheals without proper diagnosis or management.

What is IBS? Understanding Irritable Bowel Syndrome

IBS is a functional disorder of the gut — meaning the bowel looks normal on investigations (colonoscopy, biopsy) but does not function normally. The key features are:

• Abnormal gut motility (too fast or too slow)
• Visceral hypersensitivity (heightened pain sensitivity in the gut)
• Altered gut-brain communication (the "gut-brain axis")
• Changes in gut microbiome (bacteria in the intestine)

Types of IBS

• IBS-D (Diarrhoea-predominant): Frequent loose stools, urgency, post-meal diarrhoea
• IBS-C (Constipation-predominant): Infrequent, hard stools; straining; feeling of incomplete evacuation
• IBS-M (Mixed): Alternating diarrhoea and constipation
• IBS-U (Unclassified): Does not fit neatly into other categories

Symptoms of IBS

• Recurrent abdominal pain or cramping — often relieved by passing stool
• Bloating and excessive gas (flatulence)
• Diarrhoea (loose, watery stools) — often urgent
• Constipation (infrequent, hard stools)
• Alternating diarrhoea and constipation
• Mucus in stool
• Feeling that the bowel is not completely empty
• Symptoms often worse after eating
• Symptoms triggered or worsened by stress and anxiety

IBS vs IBD — What's the Difference?

Many patients confuse IBS with IBD (Inflammatory Bowel Disease — Crohn's disease and ulcerative colitis). They are very different:

• IBS: Functional disorder — no visible inflammation on colonoscopy or biopsy. Does not cause permanent bowel damage.
• IBD: Structural disease — visible inflammation, ulcers on colonoscopy. Can cause permanent damage, bleeding, fistulas, abscesses. Requires immunosuppressive treatment.

It is essential to distinguish between the two. Dr. Raman Garg performs colonoscopy and biopsy to confirm the diagnosis.

IBS Diagnosis at Bombay Gastro & Cancer Institute, Bathinda

IBS is diagnosed using the Rome IV criteria (recurrent abdominal pain, at least 1 day/week for 3 months, associated with change in bowel habits) along with ruling out organic disease:

• Blood tests: CBC, ESR, CRP (inflammation markers), thyroid function, celiac serology (anti-TTG IgA)
• Stool tests: Fecal calprotectin (differentiates IBS from IBD), stool culture (rule out infection), ova and parasites
• Colonoscopy with biopsy: Rules out IBD, colon polyps, microscopic colitis, colorectal cancer
• Hydrogen breath test: For lactose intolerance and small intestinal bacterial overgrowth (SIBO)
• Abdominal ultrasound: Rules out gallstones, ovarian cysts

IBS Treatment by Dr. Raman Garg

1. Dietary Management (Most Important)

• Low-FODMAP Diet: Reduces fermentable carbohydrates that trigger symptoms. Eliminates high-FODMAP foods (onion, garlic, wheat, dairy, beans, cauliflower, apples) for 4–8 weeks then reintroduces them to identify personal triggers.
• Regular eating schedule: Small, frequent meals; avoid skipping meals
• Adequate fibre: Psyllium (ispaghula) husk helps both diarrhoea and constipation types
• Adequate water intake (2–3 litres/day)
• Identify personal food triggers: Keep a food and symptom diary

2. Medications

• Antispasmodics: Mebeverine, hyoscine — for abdominal cramping
• Loperamide: For IBS-D — reduces stool frequency and urgency
• Laxatives (Polyethylene glycol): For IBS-C — relieves constipation
• Low-dose antidepressants: Amitriptyline (IBS-D), SSRIs (IBS-C) — modulate gut-brain axis, reduce visceral pain
• Probiotics: Lactobacillus and Bifidobacterium strains — improve gut microbiome balance
• Rifaximin: Non-absorbable antibiotic for SIBO-associated IBS
• Peppermint oil capsules: Natural antispasmodic

3. Psychological Support

• Cognitive Behavioural Therapy (CBT) — highly effective for IBS
• Mindfulness and relaxation techniques
• Gut-directed hypnotherapy
• Stress management — yoga, meditation, regular exercise

Frequently Asked Questions — IBS Treatment Bathinda