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Irritable bowel syndrome (IBS) is another condition of the “evil quadruplets.” It often coexists with endometriosis and adds to the pain of this condition. The mainstay is pain that is worsened by food and improved by defecation. It is also important to remember that IBS is diagnosed based on symptoms, and endoscopy is often performed in those patients is done to rule out any other bowel disease. This condition is best managed by a gastroenterologist but it is important to note that quite a large number of patients with this condition have spasm of pelvic floor muscles and treatment of that spasm may improve some of the IBS symptoms.
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