“…A typical patient with multi-faceted IBS needs a detailed history workup, physical and systemic examination, pertinent laboratory investigations, differential diagnosis and comprehensive treatment plan: prevention strategies such as use of prebiotics and probiotics to promote growth of beneficial GIT bacteria, i.e., gram negative bacteroides, dietary supplements including medicinal herbs and lifestyle modifications,and stress reduction through the lens of evidencebased conventional and complementary and integrative medicine (CIM) therapies [2,4, IBS preferentially afflicts females and is a multidimensional disorder [38], often presents differently in each individual and can be managed better with evidence-based patientcentered holistic-integrative approaches. A judicious combination of pharmacotherapy with complementary and alternative medicine (CAM) therapies including acupunctureis evidenced to produce cost-effective and best outcomes for patients with IBS compared to placebo [2,4,[47][48][49][50][51][52][53][54][55]. Pharmacotherapies needing comparative research, and used relatively more in IBS-D include, but not limited to, antispasmodics, lowdose tricyclic antidepressants and specific serotonin reuptake inhibitors (SSRI), 5-HT-3 and [54,56].…”