Irritable bowel syndrome (IBS) is one of the most commonly diagnosed conditions in primary care today. It is a digestive disturbance that includes change in stool frequency and form alongside abdominal discomfort. This condition can be the result of an imbalance in the bacterial balance of the microbiome in the colon or, in the cases of SIBO (small intestinal bacterial overgrowth) in the small intestine. My approach to identifying the source of IBS includes a comprehensive history of symptoms and diagnostic testing to assess for root cause and imbalance. Treatment approaches vary including dietary and nutraceutical interventions as well as pharmaceutical approaches when necessary.