In simple words: Mixed irritable bowel syndrome (IBS-M) means your bowel habits switch between constipation (hard stools) and diarrhea (loose stools). You might also have belly pain, bloating, and gas.It's diagnosed based on your symptoms and how often you have these bowel problems.

Mixed irritable bowel syndrome (IBS-M) is a subtype of irritable bowel syndrome where individuals experience both diarrhea and constipation, often alternating.Symptoms may also include abdominal pain, bloating, gas, mucus in stool, and a feeling of incomplete evacuation. Diagnosis is based on Rome IV criteria, which requires experiencing hard, lumpy stools (Bristol Stool Form Scale Types 1 or 2) during at least 25% of bowel movements on symptomatic days and loose, mushy stools (Types 6 or 7) during at least another 25% of bowel movements on symptomatic days.The alternating pattern can occur rapidly (hours or days) or over longer periods (weeks or months).

Example 1: A 35-year-old female presents with a history of alternating diarrhea and constipation, abdominal pain, bloating, and gas for the past six months.She reports that her symptoms vary in severity and frequency. Diagnosis of IBS-M is made based on Rome IV criteria and a thorough workup excluding other causes of her symptoms. Treatment is initiated with dietary changes, stress reduction techniques, and antispasmodic medication., A 28-year-old male reports episodes of both constipation and diarrhea, often occurring within the same week.He experiences abdominal discomfort, primarily cramping, and reports increased gas and bloating.The physician rules out other gastrointestinal conditions and diagnoses IBS-M based on symptom presentation. The patient is educated about dietary modification and encouraged to manage stress., A 40-year-old female with a past history of severe gastroenteritis presents with persistent alternating diarrhea and constipation for several months. She also complains of abdominal pain and a feeling of incomplete bowel evacuation after a movement.The physician diagnoses IBS-M (post-infectious) and recommends a combination of dietary counseling, regular exercise, and medication to manage her symptoms.

Detailed patient history including bowel habits (frequency, consistency, presence of blood or mucus), abdominal pain characteristics, associated symptoms (bloating, gas, nausea, urgency), duration of symptoms, and any potential triggers (stress, food).Results of any relevant investigations such as stool tests to rule out infections or inflammatory bowel disease should also be documented.Diagnosis based on the Rome IV criteria.

** IBS-M is a complex condition and its management is often multidisciplinary, potentially involving dieticians and mental health professionals in addition to physicians. The use of symptom tracking apps can also be helpful for both diagnosis and treatment monitoring.