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IBS is characterized by alternating diarrhea and constipation, often with one of these conditions being dominant. It is considered a functional (rather than organic) disorder in modern medicine, and managed with anti-anxiety medicines and other pharmaceuticals. In Functional medicine, organic pathology may underlie the condition, and include gut permeability issues, genetic defect, food allergies, and dysbiosis. In Chinese medicine, root differentiations include a variety of liver-stomach imbalances, complicated by spleen deficiency. All medical systems acknowledge the role of internalized stress as a precipitating factor. We will discuss TCM differentiation with formulas (both custom and product), theories and lab tests according to Functional medicine, the usefulness of certain nutritional supplements, and the role of diet and stress management.