Irritable bowel syndrome is a symptom complex that appears to have multiple causes. In those patients with diagnosable psychiatric illness, treating the psychiatric illness often leads to considerable improvement of the symptoms of irritable bowel syndrome. For almost all symptomatic patients, a caring, thoughtful physician can be very therapeutic by educating the patient, being supportive, offering realistic reassurance and adequate time, and prescribing a minimum of medication judiciously. As in many areas of medicine, a physician can succeed in "taking the hurt out of the pain," thereby vastly improving the patient's quality of life.