I. What is functional gastrointestinal disease
Functional gastrointestinal disease refers to patients with gastrointestinal symptoms, but no organic lesions in the gastrointestinal examination, so it is also called gastrointestinal neurosis. If further subdivided, those with mainly stomach symptoms are called “non-ulcer dyspepsia” and those with mainly intestinal symptoms are called “irritable bowel syndrome”.
Second, the incidence of functional gastrointestinal disease
The disease occurs all over the world, according to the literature, some developed countries than in developing countries, such as the United States, the incidence of women up to 80%, mainly in knowledge women. There are no specific statistics in China, but experts estimate that about 1/3 of the general population (especially the middle-aged and elderly) has symptoms related to this disease. According to the statistics of dozens of hospitals in Shanghai, this disease accounts for about 2/3 of the total number of visits to the digestive system, which shows that the incidence of this disease is quite high in China.
Under what circumstances is the disease likely to occur?
The cause of the disease has not been completely elucidated, and may be related to one or more of the following factors.
1. Psychiatric factors: most of them have anxiety, depression, restlessness, hypochondria and fear of cancer, and a few have insomnia, nervousness, exaggerated speech and other psychiatric symptoms. Patients often describe their disease in a very serious way and worry about it all day long, which affects their normal life, study and work. In addition, the disease is also associated with mental stimulation or mood swings, such as a sudden increase in workload, increased economic burden, fierce competition at work, fast-paced life, little time for rest, layoff and unemployment, death of relatives, interpersonal tension and family disputes. Because mental factors can affect the movement, secretion and blood supply of the gastrointestinal tract through the autonomic nervous system, leading to the occurrence of the disease.
2, genetic: investigation found that in the same family can have more than one person suffering from the disease, parents suffer from the disease, children also suffer from the disease is not uncommon, and there are even several generations of patients.
3, food: Some people have observed more than 20 kinds of food, and found that acidic fruits, fresh salad, spices, alcohol, chili and strong coffee are the triggers of the disease.
What are the manifestations of the disease?
Those who have mainly stomach symptoms (mostly seen in non-ulcer dyspepsia), the main manifestations are
1, neurological vomiting: sudden vomiting after eating, no obvious nausea before vomiting, vomiting without pain, vomiting less (sometimes also a lot), vomiting can be eaten as usual, does not affect appetite and intake. Therefore, despite prolonged vomiting, patients are rarely malnourished.
2. Neurological belching: Patients often have repeated continuous belching (can belch out a high-pitched sound), mistaking it for gas in the stomach and causing fullness and discomfort.
3, anorexia nervosa: Some people consciously diet for fear of gaining weight or to lose weight, and in the long term, this can lead to an aversion to food and a loss of hunger. Clinical manifestations are, eating less, continuous wasting, and cachexia may appear in the late stage.
4.Other symptoms: intermittent vague pain in the upper abdomen, abdominal discomfort, nausea, acid reflux, heartburn, loss of appetite, bloating after meals, farting, insomnia, fatigue, chest tightness, shortness of breath, palpitations, sweaty hands and feet, head and facial fever and dizziness, etc. Abdominal pain is not related to diet, but closely related to mental and emotional.
Those who have mainly intestinal symptoms (mostly seen in irritable bowel syndrome), mainly manifest as
1, abdominal pain type: mostly distension or discomfort, but also transient severe pain, relieved after defecation or exhaustion.
2, diarrhea and constipation type: diarrhea type stool paste or thin stool, and a lot of mucus, several times a day, often in the early morning or the second half of the night (commonly known as dawn diarrhea or five night diarrhea), diarrhea without abdominal pain. In the constipated type, there may be no stool for several days, with crampy abdominal pain during defecation, and hard, rocky pebble or sheep fecal ball-like stool may be excreted. These two types of bowel movements often alternate.
3, postprandial abdominal pain type: abdominal pain occurs after eating and cannot be relieved by defecation or exhaustion.
Five, this disease by what method to diagnose
There is no specific diagnosis method, and the diagnosis is mainly made by combining the following information.
1.Symptoms: one or more of the above clinical symptoms; good general condition, no fever, most of them without wasting.
2, examination: gastroscopy, colonoscopy, whole gastrointestinal tract barium angiography did not see organic lesions of the gastrointestinal tract (colonoscopy and whole gastrointestinal tract barium angiography occasionally see intestinal spasm); liver, biliary, pancreatic ultrasound, CT and other examinations are normal; repeated (at least 3 times) stool routine examination and culture, fecal occult blood test are negative.
3, past history: no history of chronic gastritis, dysentery, intestinal parasites and other gastrointestinal diseases.
4, mental status: there may be mental allergy, impatience, nervousness or depression, etc.
In short, the disease is characterized by many subjective symptoms and few or no positive findings in objective examinations.
VI. How to prevent and treat the disease?
At present, there is no special treatment for functional gastrointestinal disease, the common prevention and treatment measures are.
1, maintain a good psychological state: broad-mindedness, emotional optimism, cheerfulness, open-mindedness, is the best measure to prevent the disease.
2, treatment of psychological disorders: all negative psychological factors that may cause the disease should be avoided as much as possible, especially for those who have fear of disease or cancer, to make patients understand that the disease is a functional disease, absolutely not life-threatening, so that they can eliminate concerns and enhance confidence in curing the disease.
3.Treatment of neurological disorders: for those who are nervous, sedatives such as eszopiclone (once named Shule Valium), cypress heart pills and glutamate can be given; for those who are depressed, amitriptyline and clomipramine can be applied; for those who are mentally anxious, desipramine and alprazolam (Jiajing Valium) can be given orally.
4, treatment of gastrointestinal symptoms: for abdominal pain, atropine, scopolamine, belladonna and, if necessary, dicyclomine or poppy bases; for diarrhea, diphenoxylate (phenelzine), loperamide (easy to stop), etc.; for constipation, bishacodyl (poo stop), phenolphthalein, open cologne, senna and marenza, etc., and eat more vegetables and fruits; for heartburn, acid reflux, omeprazole (Loserai), nitisin, etc. Nystatin, etc.; for abdominal distension with domperidone (morbutrin), cisapride, etc.; for nausea and vomiting with metoclopramide (methotrexate) and trichlorobutanol (chlorobutanol), etc.; for indigestion with pepsin combination, pancreatic enzymes, shampoos and stomach pills, etc.
5, diet regulation: eat less and more meals, eat nutritious and easy to digest food, avoid eating too cold, too hot and stimulating food (ginger, onion, garlic, chili, mustard, etc.).
6, Chinese medicine treatment: to dredge the liver and Qi, strengthen the spleen and dampness, regulate the spleen and stomach, use Chai Hu Dredging Liver San, Si Wei San, Ginseng and Bai Zhu San, and Pai Zi Rizhong Wan.