In clinical work and in life, we often see people who have abdominal pain and diarrhea when they are slightly exposed to cold, hot, sour or spicy food, and the number of diarrhea is even more than 10 times per day; some people are constipated and have diarrhea at the same time. Some people are diagnosed with “irritable bowel syndrome” and repeatedly go to the hospital without any abnormalities, so they are often not noticed, but the above symptoms last for several years or for life; they bring a lot of physical and mental pain to the patients, and also bring a lot of inconvenience to their work, study and daily life.
Definition of irritable bowel syndrome
Irritable bowel syndrome (IBS) is a global disease characterized by abdominal pain or abdominal discomfort with changes in stool characteristics and bowel habits (constipation or diarrhea). The pathogenesis of IBS in adults is not well understood, as it is associated not only with intestinal infections and food intolerance, but also with psychological factors such as depression and anxiety.
In the past, the names used to diagnose this disease were very confusing, such as gastrointestinal neurosis, allergic colitis, spastic colitis, irritable colitis, chronic colitis, and gastrointestinal dysfunction have all been used.
Clinical features of IBS
1. Different degrees of abdominal pain with variable locations, mostly in the lower and left lower abdomen, and relieved by defecation or exhaustion. Some foods such as coarse-fiber vegetables, coarse-quality fruits, strong condiments, wine, and cold drinks can induce abdominal pain. The abdominal pain does not worsen progressively. No seizure during sleep.
2, chronic, frequent episodes of diarrhea with pain: generally 3-5 times a day, a few severe episodes of stool up to a dozen times, the stool is mostly thin paste, can also be thin watery or formed soft stool; diarrhea or unformed stool sometimes alternate with normal stool or constipation.
3, with painful chronic, frequent episodes of constipation: difficult to defecate, dry stool, small amount, sheep feces or fine rod-shaped, the surface can be attached to mucus. A significant proportion of patients are accompanied by insomnia, anxiety, depression, dizziness, headache and other psychiatric symptoms.
Diagnosis of IBS
According to the International Rome III criteria, the diagnosis is confirmed by the presence of symptoms in the 6 months prior to the diagnosis and by meeting the diagnostic criteria in the last 3 months.
Recurrent abdominal pain or discomfort on at least 3 days per month in the last 3 months with 2 or more of the following.
1. relief of symptoms after defecation.
2.A concomitant change in the frequency of defecation.
3. accompanied by a change in stool characteristics.
The following symptoms may support the diagnosis of IBS.
1. abnormal frequency of defecation: ≤3 times/week or >3 times/d
2. abnormal stool properties: lumpy/hard stool; loose stool/thin watery stool
3, straining to defecate.
4, feeling of urgency in defecation or incomplete defecation.
5, discharge of mucus.
6.Abdominal distension.
Many patients are diagnosed with irritable bowel syndrome only when they repeatedly experience the above symptoms, go to the hospital for the necessary examination of the gastrointestinal tract, and find no organic changes. Patients who have just started to have symptoms, or young patients with persistent diarrhea, with blood in the stool, emaciation, anemia, or who have recently traveled, need to be further examined. patients over 50 years of age should be screened for colon cancer.
Key points in the prevention and treatment of IBS
Patients with IBS can benefit from lifestyle changes. Maintaining an optimistic and stable mood, relaxing the body and mind, improving sleep, listening to music and exercising properly on a daily basis can reduce anxiety and help relieve intestinal symptoms.
Changes in dietary habits may also help. Avoid foods with suspected intolerance, such as shrimp, crab, milk, peanuts, etc. Spicy, frozen, greasy and cold foods as well as tobacco, alcohol, coffee and chocolate should be avoided. Eat a rationed diet, do not over-starve or over-feed, and develop good living habits. Patients with diarrhea should eat less residue, easy to digest, low-fat food; constipated people should eat more fiber vegetables, coarse grains, etc.
Regulate intestinal flora to supplement normal flora, appropriate amount of bifidobacteria and lactobacilli, etc. Drinking appropriate yogurt every day is a relatively easy and effective method.
Other possible treatments may include: psychological counseling for patients with severe anxiety and depression; application of antidiarrheal drugs for IBS where diarrhea is the main symptom; low-dose antidepressants to help relieve intestinal pain constipation is given as a medication to laxative.