1.General treatment Establish good living habits. Avoid foods that trigger symptoms in the diet, which varies from person to person. In general, it is advisable to avoid gas-producing foods such as dairy products and soybeans. High-fiber foods can help improve constipation. For insomnia, anxiety can be given appropriate sedative drugs.
2, drug treatment (1) gastrointestinal antispasmodics: anticholinergic drugs can be used as short-term symptomatic treatment of abdominal pain with heavy symptoms. Calcium channel blockers such as nifedipine have certain effect on abdominal pain and diarrhea, and pivibromine is a calcium channel blocker that selectively acts on smooth muscle of gastrointestinal tract, so there are few side effects.
(2) antidiarrheal drugs: loperamide or compound difenoxil has good antidiarrheal effect and is suitable for those with heavy diarrhea symptoms, but should not be used for a long time. General diarrhea is appropriate to use adsorption antidiarrheal drugs such as Simethicone, medicinal charcoal, etc.
(3) laxatives: laxatives are used as appropriate for constipation-type patients, but should not be used for a long time. Hemicellulose or hydrocolloid, which is not digested and absorbed in the intestine, but has a strong hydrophilic, absorbing and swelling in the intestinal lumen to increase the water and volume of intestinal contents, to promote intestinal peristalsis, softening the role of stool, is considered to be a more ideal drug for the treatment of IBS constipation. Such as psyllium preparations and natural polymeric polysaccharides.
(4) antidepressants: for abdominal pain, diarrhea symptoms and the above treatment is ineffective and no significant psychiatric symptoms can be tried.
(5) Omeprazole enteric tablets, glutamate tablets, trimebutine maleate tablets, combination therapy.
(6) Intestinal microecological agents: such as Bifidobacterium, Lactobacillus and other preparations, can correct the intestinal flora imbalance, effective for abdominal distension and diarrhea. Gastrointestinal motility drugs such as cisapride can help improve constipation.
(7) gastrointestinal dynamics of two-way regulators: trimebutine maleate tablets, it acts on the peripheral ENS opioid receptors, direct action on the smooth muscle of the gastrointestinal tract, affect the release of gastrointestinal peptides three ways to regulate gastrointestinal dynamics disorders.
3, psychological and behavioral therapy including psychotherapy, hypnosis, biofeedback therapy, foreign reports have some efficacy.
It is important for the physician to understand and guide compassionately. The physician must explain the nature of the underlying disease and convincingly confirm to the patient that no organic disease exists. This requires time to listen to the patient and explain to them the normal intestinal physiology and the hypersensitivity of the gut to stressful foods or medications. These explanatory efforts provide the basis for attempting to re-establish normal patterns of bowel movement and selecting specific therapies appropriate for the patient, and should seek, assess, and treat psychological stress, anxiety, and emotional abnormalities. Regular physical activity helps to relieve stress and promote bowel function, especially in patients with constipation.
According to the clinical manifestations of this disease, it belongs to the category of “abdominal pain”, “constipation” and “depression evidence” in Chinese medicine. From the point of view of the lesion, although the disease is in the large intestine, but it is related to the dysfunction of the liver, spleen, stomach and other internal organs.
The etiology of the disease can be summarized as follows: emotional and mental disorders cause liver qi stagnation, liver and spleen disharmony, resulting in intestinal qi disorder and intestinal conduction disorder; or due to cold in the day and spleen yang weakness and damage to kidney yang, yang deficiency can not warm the middle jiao, abnormal transportation and diarrhea. In addition, diet, fatigue and cold temperature disorders can affect the dysfunction of the internal organs and lead to this disease. The clinical application of Chinese medicine evidence-based treatment can receive better results.
Warm tip: please combine the specific medication with clinical, by the doctor interview guidance shall prevail.