Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by abdominal pain or discomfort accompanied by changes in bowel habits and/or stool characteristics. In recent years, irritable bowel syndrome has been recognized as a global functional disease with the highest incidence in humans.
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 treatment, 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 can be clinically classified into the following three subtypes, namely, diarrheal irritable bowel syndrome (IBS-D), constipated irritable bowel syndrome (IBS-C), and mixed irritable bowel syndrome (IBS-M). Since the various subtypes of IBS can overlap with each other, and patients with IBS can switch between different subtypes, treatment is based on the frequency and severity of clinical symptoms such as diarrhea, constipation, abdominal pain and abdominal distension.
Based on the current Rome III diagnostic criteria, the main symptoms of IBS are abdominal pain and abdominal discomfort with changes in bowel habits. 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 Antibiotics rifaximin, a derivative of rifamycin, has low bacterial resistance and low bioavailability because it is mostly absorbed in the intestine and less than 0.5% of the oral dose is absorbed systemically. The drug has the advantages of low toxicity and side effects and less drug interactions.
2. Constipated irritable bowel syndrome (IBS-C) 2.1 Fiber supplements 2.2 Laxatives including osmotic laxatives, stimulant laxatives and stool softeners, etc.
2.3 Prokinetic agents 3. Abdominal pain and discomfort 3.1 Antispasmodic agents such as the gastrointestinal highly selective calcium channel blocker pivelbromide, the peripheral opioid receptor agonist trimethoprim, the antispasmodic and anticholinergic agent oxybutynin
3.2 Drugs for psychiatric disorders 3.3 Probiotics