Inclusion Criteria:  Patients are eligible for the study if all of the following criteria are met:  Patients with irritable bowel syndrome as per Rome IV diagnostic criteria Symptom characteristics of IBS according to Rome III and IV criteria Patients must provide witnessed written informed consent prior to any study procedures being performed Patients aged between 20-65 years Male or female patients  Exclusion Criteria:  Exclusion criteria including:  Unable to provide or understand written informed consent. Pregnancy. Receiving antibiotics or narcotics within 90 days prior to enrollment. Receiving new prebiotics, probiotics within 90 days prior to enrollment. Current infection. History of inflammatory bowel disease. Thyroid disease. Major psychiatric disorders, including clinical anxiety or depression and previous use of anxiolytics and antidepressants. Previous stroke, intracerebral hemorrhage, or central nervous system diseases. Malignancy.