1)      Irritable Bowel Syndrome – Manning criteria: onset of abdominal pain associated with more frequent bowel movements, onset of abdominal pain associated with loser bowel movements, pain relieved by defecation, visible distension, subjective sensation of incomplete rectal evacuation most of the time, mucus passage most of the time. Rome III criteria: recurrent abdominal pain or discomfort at least 3 days per month in the last 3 months AND 2 or more of the following – abdominal pain improvement with defecation, abdominal pain onset associated with a change in frequency of stools, abdominal pain onset associated with a change in the appearance of stools.  Other common symptoms seen in IBS but not part of the criteria list include constipation (< 3 bowel movements/week), diarrhea (> 3 bowel movements/day, lumpy-hard-lose-watery stools, defecation straining, urgency, sense of incomplete evacuation of the rectum, mucus passage, bloating).  In the presence of a typical history and Rome – III criteria and in the absence of red flags, no further testing is necessary. Tx – PCT, management of illness fears and concerns, worries and fears, management of psychosocial triggers, management of associated anxiety, depression or any other psychiatric syndromes, symptomatic management, drug therapy – loperamide for diarrhea 2 mg after each stool up to a maximum of 16 mg/day, TCAs for chronic pain therapy with amitriptyline 10-150 mg daily, desipramine 10-150 mg daily, doxepin 10-200 mg daily, imipramine 10-150 mg daily, trazodone 25-50 mg daily basically lower doses than for depression.