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Irritable Bowel Syndrome Mixed
Mixed Irritable Bowel Syndrome (IBS-M) blends diarrhea and constipation, triggering pain, bloating and unpredictable trips to the bathroom. At GastroDoxs in Houston, board-certified Dr. Scott offers personalized diagnosis, diet strategies, medications, advanced therapies-guiding you toward lasting relief and restored confidence.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
What is Irritable Bowel Syndrome Mixed?
Irritable Bowel Syndrome Mixed (IBS-M) is a digestive disorder that causes both constipation and diarrhea, along with stomach pain or bloating.
Common Causes and Risk Factors
Stress and anxiety affecting gut-brain communication
Hormonal fluctuations (commonly around menstrual cycle)
Family history of IBS
Onset often before age 50
Signs and Symptoms
Abdominal pain or cramps that ease after a bowel movement
Alternating episodes of diarrhea and constipation
Excess gas and bloating
Sudden urgency to go, then periods with no bowel movements
Presence of mucus in the stool
How Dr. Scott Diagnoses This Condition?
Dr. Scott uses a step-by-step approach:
Medical History and Physical Exam
He reviews your epigastric pain patterns, episodes of diarrhea and constipation, diet, stressors, medications and family history.
Rome IV Criteria
Applies the Rome IV guidelines to confirm a mixed IBS diagnosis by correlating pain relief with bowel movements and stool form changes.
Blood Tests
Checks celiac serology, thyroid function, complete blood count and inflammatory markers to rule out other causes.
Stool Studies
Pathogen panels to exclude infections.
Fecal calprotectin or lactoferrin to rule out inflammatory bowel disease.
Endoscopy & Colonoscopy (if indicated)
Upper endoscopy evaluates persistent epigastric pain (GERD, H. pylori) and colonoscopy is used when alarm features are present or diagnosis is unclear.
Additional Testing
Breath tests for small intestinal bacterial overgrowth or lactose intolerance.
Dietary review and symptom diary to identify personal triggers.
Treatment
Our Team offers a full range of care for Mixed Irritable Bowel Syndrome (IBS-M).
1. Lifestyle and Diet Modifications
Low-FODMAP diet: eliminate trigger carbs, then reintroduce one by one
Balanced fiber intake: soluble fiber to help both loose and hard stools
Stress reduction: mindfulness, gentle breathing exercises, or therapy
Regular exercise: walking, swimming, or other activities to support digestion
2. Medications
Antispasmodics (e.g., dicyclomine) to relieve cramps
Laxatives (e.g., polyethylene glycol) for constipation relief
Anti-diarrheals (e.g., loperamide) to control diarrhea
Probiotics to support a healthy gut microbiome
3. Advanced Therapies and Procedures
Neuromodulation therapy to improve gut-brain communication
Biofeedback therapy to enhance bowel-muscle control
Ongoing monitoring and personalized adjustments to your care plan
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
What is IBS-M?
IBS-M is a form of irritable bowel syndrome characterized by alternating episodes of diarrhea and constipation.
What's the ICD-10 code for IBS-M?
The ICD-10 code for Mixed Irritable Bowel Syndrome is K58.4.
How is IBS-M different from IBS-D or IBS-C?
IBS-D involves primarily diarrhea, IBS-C primarily constipation, while IBS-M includes both loose and hard stools.
Can diet help manage IBS-M?
Yes. Many patients benefit from a Low-FODMAP diet, balancing soluble fiber, and identifying individual food triggers.
When should I see a doctor for IBS-M?
See Dr. Scott if you have persistent symptoms, blood in your stool, unexplained weight loss, or impairment of daily activities.
Are there advanced treatments for IBS-M?
Yes. Neuromodulation and biofeedback therapies can help patients whose symptoms are difficult to control.
Is IBS-M dangerous?
IBS-M is not life-threatening but can significantly impact quality of life. Appropriate diagnosis and management can improve symptoms.
