Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by abdominal pain or abdominal discomfort accompanied by changes in bowel habits and/or stool characteristics.
In recent years, irritable bowels syndrome (IBS) has been recognized as a global functional disorder with the highest incidence in humans, affecting about 5% to 20% of the population worldwide. There is a trend toward younger diagnosis, mostly in people younger than 50 years of age.
Due to the multifactorial and complex pathogenesis of IBS, it is difficult to cure, and the symptoms are long-lasting or recurrent. Patients frequently seek medical care, which seriously affects their quality of life and mental and physical health.
Pathogenesis.
1, psychosomatic and central nervous abnormalities.
2, Inflammation and infection.
3. intestinal flora and metabolic abnormalities.
4, food and IBS.
5, genetic polymorphisms and IBS susceptibility.
IBS
IBS can be clinically classified into three subtypes, namely, diarrheal irritable bowel syndrome (IBS-D), constipated irritable bowel syndrome (IBS-C), and mixed irritable bowel syndrome (IBS-M), and it has been suggested that each of these subtypes accounts for 1/3 of the population with IBS. The frequency and severity of clinical symptoms such as diarrhea, constipation, abdominal pain and abdominal distension are the main factors in the treatment of IBS.
Based on the current Rome III diagnostic criteria, the main symptoms of IBS are abdominal pain and abdominal discomfort with altered bowel habits, so the diagnosis of IBS is based on symptoms of constipation, bloating and abdominal discomfort, and the exclusion of risk factors for organic gastrointestinal disease. It is important to emphasize that IBS is a diagnosis of exclusion and should be carefully differentiated from early gastrointestinal tumors and mild inflammatory bowel disease with the help of relevant tests. These specific laboratory tests include: complete blood count, C-reactive protein, fecal calprotectin, serologic tests for abdominal disease, and age-related endoscopy for colorectal cancer.
Treatment.
1. Diarrheal irritable bowel syndrome (IBS-D)
1.1 Antidiarrheal drugs.
1.2 5-hydroxytryptamine (5-HT3) receptor antagonists.
1.3 Antibiotic rifaximin, a derivative of rifamycin, has the advantages of low toxicity and fewer side effects and drug interactions because it is mostly absorbed in the intestine and less than 0.5% of the oral dose is absorbed systemically, with less bacterial resistance and lower bioavailability.
2. Constipated irritable bowel syndrome (IBS-C)
2.1 Fiber supplements.
2.2 Laxatives including osmotic laxatives, stimulant laxatives and stool softeners.
2.3 Prokinetic drugs.
3. Abdominal pain and discomfort
3.1 Antispasmodics such as the gastrointestinal highly selective calcium channel blocker pivelbromine, the peripheral opioid receptor agonist trimethoprim, the antispasmodic and anticholinergic drug oxybutynin.
3.2 Drugs for psychiatric disorders.
3.3 Probiotics.