Irritable bowel syndrome (IBS) is a group of persistent or intermittent episodes of abdominal pain, bloating, bowel habits and/or stool traits that change clinically, but lacks gastrointestinal structure and biochemical abnormalities. Dysfunctional disease. The patients are mainly young and middle-aged, and the age of onset is more common in 20 to 50 years old. Women are more common than men, and have a tendency to familial aggregation, often accompanied by other gastrointestinal disorders such as functional dyspepsia. According to the characteristics of stool, IBS is divided into four clinical types: diarrhea, constipation, mixed and amorphous.
The etiology and pathogenesis of IBS are not well understood, and are considered to be the result of a combination of gastrointestinal motility abnormalities, visceral paresthesia, abnormal brain regulation, inflammation, and psychosis.
Clinical manifestations:
IBS has no specific symptoms, but has some characteristics compared with organic gastrointestinal diseases: slow onset, intermittent onset; long course but not affected by general health; symptoms appear or aggravate often with mental factors or stress State related; obvious during the day, relieved after nighttime sleep.
Symptom
(1)Abdominal pain or abdominal discomfortis the main symptom of IBS, accompanied by abnormal frequency or shape of stool, abdominal pain is more relieved than after bowel movement, some patients are easy to appear after eating, abdominal pain can occur in any part of the abdomen, localized or diffuse The pain is diverse. Abdominal pain does not increase progressively, and there are very few people who wake up after sleep at night.
(2) Diarrhea
(3) constipation Difficulty in defecation, dry stool, less amount, can bring more mucus, constipation can be interrupted or alternate with diarrhea, often accompanied by defecation.
(4) bloating is heavier during the day, especially in the afternoon, after nighttime sleep.
(5) Upper gastrointestinal symptoms Nearly half of the patients have upper gastrointestinal symptoms such as burning sensation of the stomach, nausea, and vomiting.
(6) Parenteral symptoms: back pain, headache, palpitations, frequent urination, urgency, sexual dysfunction and other parenteral manifestations are more common than organic bowel disease. Some patients still have different levels of mental and mental abnormalities, such as anxiety. , depression, nervousness, etc.
Treatment:
The current treatment of IBS is limited to symptomatic treatment. The goal of treatment is to eliminate patient concerns, improve symptoms, and improve quality of life. The principle of treatment is based on a good doctor-patient relationship, symptomatic treatment according to the main symptom types and graded treatment according to the severity of the symptoms.
Adjust the diet
Learn more about the patient's eating habits and its relationship with symptoms, avoid sensitive foods, avoid excessive fat and irritating foods such as coffee, tea, alcohol, etc., and reduce the intake of gas-producing foods (dairy products, soybeans, lentils, etc.) . High-fiber foods (such as bran) can stimulate colon movement and have a significant effect on improving constipation.
2. Psychological and behavioral therapy
Patient interpretation of the patient, including psychological treatment, biofeedback therapy, etc., for those with insomnia, anxiety and other symptoms, can be appropriate to sedative drugs.
3. Drug treatment
4. Chinese medicine treatment
Chinese medicine divides IBS into syndromes of large intestine heat syndrome, cold and heat syndrome, spleen and stomach weakness syndrome, liver qi spleen syndrome, liver qi stagnation syndrome, etc., through syndrome differentiation and treatment, using traditional Chinese medicine and acupuncture, etc., the treatment of IBS is better efficacy.
