Case: Xiao Wang has been suffering from recurrent stomach discomfort and frequent diarrhea for almost 10 years since he was more than 10 years old. In the first few years, it was slightly better, 3~5 times a day, but in the last two years, it was especially frequent, up to 15 times. The abdominal cramps are often felt when drinking cold drinks, drinking alcohol, eating stimulating food, and working under stress. Diarrhea is frequent in a short period of time, especially at night before going to bed. At least 3 times as well. Many times this year, I have had diarrhea all night long, and some time ago, I have been pooping yellow thin water. Multiple gastroscopies, colonoscopies, abdominal ultrasound, and liver and kidney function tests have not shown any significant abnormalities? What kind of disease should I consider?
What is irritable bowel syndrome?
Irritable bowel syndrome is a disorder of gastrointestinal function characterized by abdominal pain or discomfort accompanied by changes in bowel habits and/or stool characteristics, and the absence of organic lesions that could explain these symptoms on routine clinical examination. Irritable bowel syndrome is a common outpatient disease with a high prevalence among young people!
The overall prevalence of irritable bowel syndrome in our general population is 6.5%, with a higher prevalence among adolescents. The prevalence is slightly higher in females than in males; it occurs in all age groups, but is more common in young and middle-aged people, and decreases in the elderly.
Irritable bowel syndrome is divided into 3 categories, which are interchangeable at the same time
Irritable bowel syndrome (IBS) can be clinically divided into three subtypes, namely, diarrheal irritable bowel syndrome (IBS-D), constipated irritable bowel syndrome (IBS-C), and mixed irritable bowel syndrome (IBS-M), and some studies suggest that each of these three subtypes accounts for 1/3 of the population with IBS.
Since various subtypes of IBS can overlap with each other, and patients with IBS can switch between different subtypes, treatment is mainly based on the frequency and severity of clinical symptoms such as diarrhea, constipation, abdominal pain and abdominal distension.
The involvement of psychological factors causes irritable bowel syndrome to be a small, difficult-to-treat disease
Common pathogenesis
1. psychosomatic and central nervous abnormalities.
2, inflammation and infection.
3. intestinal flora and metabolic abnormalities.
4, food and IBS: tobacco, alcohol, spices, cold, oil and hard, these things are more or less stimulate the gastrointestinal tract, the general public eat it does not matter, but who let your gastrointestinal tract so irritable it.
5, genetic polymorphisms and IBS susceptibility.
Psychosomatic disorders are an important factor in the development of irritable bowel syndrome. The causes of irritable bowel syndrome are still unclear, mainly abnormal gastrointestinal dynamics, abnormal visceral perception, psychiatric factors, food intolerance, etc. More experts believe that psychosomatic disorders are an important factor in the development of irritable bowel syndrome.
It has become common knowledge that psychological factors may influence the clinical symptoms, symptom types and severity of patients. Nowadays, the importance of good doctor-patient relationship is particularly emphasized, and physicians should give full understanding and communication to patients with psychological disorders and maintain long-term contact with them; cognitive therapy is a short-term psychological treatment mode, which is aimed at establishing the correct cognition of individuals, and through cognitive education and behavior, correcting patients’ The aim of cognitive therapy is to establish the correct cognition of the individual, through cognitive education and behavior, to correct the patient’s misinterpreted knowledge of the disease, to achieve the reconstruction of correct cognition, and to alleviate or eliminate psychological disorders and physical symptoms. Emphasis is placed on recognizing the benign nature of the disease suffered, the good prognosis, building confidence in treatment, and helping patients adjust their emotions and behaviors to achieve long-term relief of clinical symptoms and improved quality of life.
Danger signs beyond irritable bowel syndrome and required tests (in parentheses)
1. abnormal blood tests such as anemia (complete blood count [CBC]; fecal occult blood).
2. new symptom onset in older adults aged 50 years and older (colonoscopy).
3, blood in the stool (fecal occult blood; if positive, perform endoscopy).
4. nocturnal symptoms that awaken the individual from sleep (gastroscopy, case-specific examination).
5. unintentional weight loss (blood sedimentation [ESR]; endoscopy).
6, recent antibiotic use (Clostridium difficile toxin).
7. family history of other gastrointestinal disorders such as inflammatory bowel disease, celiac disease, or colon cancer (fecal calprotectin; ESR; endoscopy if any of these is positive; celiac disease test).