IBS-D is no more than a collection of different conditions rather than a single separate entity (see chart). Physicians frequently use this term as a “catch-all” or “wastebasket” diagnosis when an answer cannot be given to the patient. Physicians should pursue further work-up on their patients and stop only when a definite clinical entity is identified and treated satisfactorily.
To fall short in their work up and tag patients with a diagnosis of “IBS” results in dissatisfied patients that continue to change physicians in the hope of getting relief from these devastating symptoms. The term “IBS” is vague and is frequently used to satisfy the puzzled physician and a desperate patient.