first the basics--the other letters are the most prominent problem that the person has, so ibs-d is diarrhea, and ibs-c is constipation.i really go through phases with the fatigue. it can get really bad, and ironically, the more i give into the tiredness, the more tired i am. if i actually let myself sleep too much and laze around, it makes it a lot worse.the only way that i've found to combat it is a lot of work, but the only thing that's helped:1) don't sleep more than 9 hours per night (unless you're really run down, or were out partying).2) exercise at least 3 times a week. when i fall of the exercise wagon, it only takes me a week before i just feel like curling up in a corner and hibernating.3) and finally, getting out and doing stuff. it can be the last thing you want to do, but just going out and going shopping, or out for 'coffee' with a friend, can do wonders for perking me up!i know those aren't really the most scientific suggestions, but short of drugs, that's been the most successful approach i've found!good luck,midge.