Irritable bowel syndrome (IBS) is one of the most common functional disorders of the intestine in clinical practice and is a disorder of intestinal function. It is characterized by the absence of organic lesions in the intestinal wall, but by an excessive or paradoxical physiological response of the entire intestine to stimuli. It is characterized by abdominal pain, diarrhea or constipation or alternating diarrhea and constipation, sometimes with a large amount of mucus in the feces. Lu Jie, Department of Anorectology, Nantong Hospital of Traditional Chinese Medicine
IBS is a kind of intestinal motility disorder produced by adapting to mental tension and stimulation.
There is often a history of dysentery infection, no organic disorders on examination, and the clinical manifestations are alternating abdominal pain, distension, diarrhea and constipation. Therefore, the onset of the patient is mostly in the context of psychiatric factors, and psychological factors play an important role in the development of the syndrome.
In addition to organic lesions, IBS is characterized by the following.
1. abdominal pain relieved by defecation.
2, occurring at least 6 times per year.
3, if the abdominal pain described above persists for at least 3 weeks.
4. exclusion of painless diarrhea
5.Excluding painless constipation. That is, IBS is a hyperfunctional intestinal tube disease with diarrhea and abnormal defecation.
Pathology includes.
1, altered intestinal dynamics.
2, altered intestinal secretion and absorption function.
3. altered immune function.
4. Hormonal effects.
IBS can occur at any age, mostly between 20 and 50 years old, with peaks in women around 20 and 50 years old, and in men at 30 years old, with more women than men, accounting for about 3/4 of the cases.
Etiology
I. Mental factors.
The onset and exacerbation of symptoms in IBS patients are closely related to emotional stress. Factors such as severe anxiety, depression, tension, excitement and fear affect the regulation of plant nerve function and cause colonic motor and secretory dysfunction. Domestic and other reports of IBS triggered by emotional stress and other factors accounted for 45%, and some foreign reports up to 80%.
1. Gastrointestinal disorders in childhood often continue into adulthood with IBS. 1/3 of children with recurrent abdominal pain are tracked for 6-8 years after the onset of IBS, 1/3 still have a variety of functional gastrointestinal symptoms, and 1/3 are asymptomatic. Eighty percent of patients with diarrheal IBS still have the gastric colonic reflex hypersensitivity of childhood.
2, IBS patients, with a history of acute bacillary dysentery more, through repeated fecal pathogenic examination, can not be confirmed as chronic bacillary dysentery, but is thought to be post-dysentery colonic dysfunction, which is often explained by “trace reaction”.
3, the so-called “travel diarrhea” patients, although partly due to infectious factors, but many times due to travel and diarrhea, mostly IBS, due to emotional factors during travel, life and diet changes caused by intestinal dysfunction.
Second, dietary factors.
Improper diet or change in diet can trigger the syndrome, such as excessive consumption of raw and cold, spicy and fragrant products; fatty foods have a greater impact on colonic motility; high protein diet often leads to diarrhea; eating foods with too much fiber can cause dysfunction.
III. Infectious factors.
People with this sign do not belong to infectious diseases, but after intestinal infection, it is easy to induce colonic dysfunction. Infectious intestinal inflammation caused by microorganisms or parasites, for example, can also change the reactivity of the colon and induce or aggravate IBS, especially after dysentery, the incidence of the syndrome can be increased.
IV. Intestinal flora dysbiosis.
Normal human intestine is dominated by anaerobic bacteria, and aerobic bacteria are dominated by Enterobacteriaceae. After changing the type of diet or over-eating certain food, the ratio of intestinal flora is imbalanced; long-term oral antibiotic drugs, Gram-negative bacteria in the stool is reduced; aerobic bacteria in the stool of IBS patients is significantly higher than normal.
V. Genetic factors.
Many patients have the syndrome from childhood, and some patients also have the syndrome from adolescence, and there is a family history, and in the same family or family, there can be more than one person suffering from IBS disease. Therefore, the syndrome may be related to heredity.
VI. Other factors.
The influence of certain diseases such as hyper- or hypothyroidism, carcinoid tumor, diabetes mellitus, hepatobiliary system diseases, etc. can also cause IBS; peptic ulcer and chronic gastritis can often coexist with IBS; in addition, frequent laxatives, enemas and other biological and physicochemical factors, such as women’s menstrual period, can often trigger IBS.