Hi there ~
I understand your concerns. I also think that excessive pain, flatulance, irregular bowels along with lactose intolerance
and gluten sensitivity
are associated with with worsening conditions of your IBS, even though you have adequately controlled your diet and made adequate lifestyle modifications. I wonder if you have seen a psychiatrist
for medications for your stress and anxiety
as it would play a huge role in your exacerbation of IBS. I hope this helps.
Take care and have a lovely day!