Conditions
Irritable bowel syndrome: treatment by video in Puerto Rico
Irritable bowel syndrome (IBS) is a long-term condition that causes belly pain linked to bowel movements, diarrhea, constipation or both, gas and bloating. It can hurt, but it does not damage your bowel. The doctor evaluates you by video, rules out other causes with a lab order if needed and helps you build a food and treatment plan.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Sudden, severe belly pain, or a hard belly that is tender to the touch
- You cannot pass stool or gas and you are vomiting
- Vomiting blood, heavy bleeding in the stool, or black stool
- Belly pain with fever and vomiting
Help lines
At a glance
Irritable bowel syndrome (IBS)
Common symptoms
- Belly pain linked to bowel movements
- Diarrhea, constipation or both, depending on the type
- Bloating and gas
- Feeling you have not finished a bowel movement
- Whitish mucus in the stool
- Other names
- IBS · Spastic colon
- Usual test
- Blood or stool tests to rule out other causes, when needed
- Treatment
- Diet changes, medicines matched to the type, and mind-body therapies, as the medical evaluation calls for
On this page(8)
What is irritable bowel syndrome?
Irritable bowel syndrome (IBS) is a group of symptoms that happen together: belly pain linked to bowel movements and changes in how you go. Depending on the type, diarrhea, constipation or both are the main problem.
It is long-term: symptoms come and go over time. Many women find symptoms get worse during their period. According to the NIDDK, IBS can be painful but does not lead to other health problems or damage your digestive tract.
How we treat irritable bowel syndrome by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. IBS is diagnosed mainly from symptoms: belly pain at least once a week over the last 3 months, together with changes in how often you go or what your stool looks like, or pain linked to bowel movements, starting at least 6 months ago.
To rule out other causes, the doctor can give you a lab order for blood tests (anemia, infection, celiac disease) or stool tests at a lab near you. If there are warning signs, we refer you to a gastroenterologist. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text This is how you see a doctor online with us.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer. If you can, write down for a few days what you eat and when symptoms happen.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If needed, you get a lab order and a doctor’s note.
What an IBS visit costs
IBS is handled in a US$79 doctor visit, the same price for every age, with no membership. If you are already our patient, reviewing your lab results is a follow-up visit. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. We do not bill insurance. See all prices.
IBS symptoms
The most common symptoms are:
- Belly pain linked to bowel movements
- Diarrhea, constipation or both, depending on the type
- Bloating and gas
- Feeling you have not finished a bowel movement
- Whitish mucus in the stool
Treatment, and when tests are ordered
No single treatment works for everyone; many people try several before they find what helps.
- Food: more fiber, avoiding gluten, or a low FODMAP diet, which limits some sugars that ferment in the gut.
- Medicines by type: for diarrhea or for constipation; for pain, antispasmodics, peppermint oil capsules or some low-dose antidepressants. The doctor tells you which fits your case.
- Probiotics: live microorganisms similar to the ones already in your gut.
- Mind and body: cognitive behavioral therapy, gut-directed hypnotherapy and relaxation training help many people.
Most people with IBS do not need tests. The doctor gives you a lab order if another cause needs ruling out, and we refer you for a colonoscopy if there is blood in your stool, unexplained weight loss, anemia, or if symptoms started after age 50. If your pain does not fit IBS, read stomach pain.
When to go to the ER
IBS is not an emergency, but these signs are. For your safety, go to the emergency room or call 911. See when to go to the ER.
- Sudden, severe belly pain, or a hard belly that is tender to the touch
- You cannot pass stool or gas and you are vomiting
- Vomiting blood, heavy bleeding in the stool, or black stool
- Belly pain with fever and vomiting
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Is IBS dangerous?
What should I eat with IBS?
Is IBS the same as an inflamed colon?
Can I get IBS treatment by video?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (4)
- Irritable bowel syndrome (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Symptoms & Causes of Irritable Bowel Syndrome (NIDDK, NIH) (opens in a new tab) (accessed 2026-10-02)
- Diagnosis of Irritable Bowel Syndrome (NIDDK, NIH) (opens in a new tab) (accessed 2026-10-02)
- Treatment for Irritable Bowel Syndrome (NIDDK, NIH) (opens in a new tab) (accessed 2026-10-02)