Hi, Thank you for your query. I can understand your concerns. Few tests are required for patients who have typical IBS symptoms and no alarm features.Most patients should have a complete blood count and sigmoidoscopic examination; in addition, stool specimens should be examined for ova and parasites in those who have diarrhea. In those aged 40 years, an air-contrast barium enema or colonoscopy should also be performed. If the main symptoms are diarrhea and increased gas, the possibility of lactase deficiency should be ruled out with a hydrogen breath test or with evaluation after a 3-week lactose-free diet. Some patients with IBS-D (diarrhoea predominant)may have undiagnosed celiac sprue and can undergo serology testing for celiac sprue . High-fiber diets and bulking agents, such as bran or hydrophilic colloid, are frequently used in treating IBS. Anticholinergic drugs may provide temporary relief for symptoms such as painful cramps related to intestinal spasm. In IBS patients with constipation, tegaserod(5-HT4 receptor agonists) accelerated intestinal and ascending colon transit. Lubiprostone is a bicyclic fatty acid that stimulates chloride channels in the apical membrane of intestinal epithelial cells.Oral lubiprostone may be useful in the treatment of patients with constipation-predominant IBS . Regards Dr. T.K. Biswas M.D. Mumbai