Mr. Li has been farting regularly for many years, and his bowel movements are not very good, and he does not have a strong sense of bowel movements every day, and his bowels are ringing; especially his abdomen is bloated after dinner, but his appetite is always good. A few years ago, when I was away on a business trip, I had a stomach upset once, and then it got better, and then it slowly formed like this now. The current symptoms are farting every day and intestinal tinnitus, in addition, I can’t drink milk, and the symptoms are worse when I drink it (it used to be normal). According to the patient’s description of his condition, the bowel sounds (intestinal “singing”) mentioned by him are called “bowel sounds” in medical science, and when combined with the patient’s irregular bowel movements and frequent farting, it can be considered as active or hyperactive bowel sounds. The patient had a tummy upset before the “singing” (medically known as acute enteritis), and the symptoms can be aggravated after drinking milk, so the patient is most likely suffering from post-infection intestinal dysfunction (medically known as irritable bowel syndrome). Irritable bowel syndrome is a common intestinal disease characterized by abdominal discomfort or abdominal pain accompanied by changes in the number of bowel movements or the nature of stools, and is a heterogeneous group of multifactorial functional bowel disease that is prone to recurrent episodes, and can be divided into diarrhea, constipation, alternating diarrhea and constipation and failure to subtype according to the characteristics of clinical manifestations. Its prevalence is about 10-20% in the general population, mostly in young and middle-aged people, with a male to female ratio of 1:2. The causes of its development are still not fully understood, and the possible causes are: gastrointestinal kinetic disorders; abnormal visceral perception functions; mental anxiety, depression and sleep disorders; intestinal infections or intestinal flora dysbiosis; intolerance to certain foods, etc. Irritable bowel syndrome after intestinal infection may be related to the dysbiosis of intestinal flora and altered intestinal immune function caused by the infection. At present, the diagnosis of irritable bowel syndrome is based on the internationally accepted Rome III criteria: abdominal discomfort or abdominal pain for at least 3 of the past 6 months, which can be discontinuous and have 2 of the following 3 symptoms: (1) abdominal discomfort or abdominal pain can be relieved after defecation; (2) change in the number of stools, such as the original number of 1-2 stools per day is now 3-4, etc.; (3 (3) change in the shape of stool, such as rotten stool, mucus stool or watery stool. The following symptoms may support the diagnosis: change in stool frequency, change in stool shape, change in the process of defecation, mucus stool, and a feeling of abdominal distention or bloating. It is emphasized that the diagnosis of irritable bowel syndrome requires the exclusion of intestinal dysfunction caused by organic diseases of the intestine. What is the clinical significance of bowel “singing”? How can we determine our health status through the performance of bowel “singing”? In medicine, intestinal sounds are the intermittent gurgling or gas-over-water sounds produced by the flow of gas and liquid in the intestine when the intestines are moving. Under normal circumstances, the bowel sounds are about 4-5 times/minute, and their sound and pitch are highly variable. They are frequent and obvious after meals, sparse and faint at rest, and can be enhanced by stimulating the abdominal wall with hands. When the bowel sounds are greater than 10 times/minute, it means that the intestinal peristalsis is enhanced, if accompanied by the tone is not particularly high, it is called active bowel sounds, mostly seen in hunger, acute gastroenteritis, after taking laxatives, gastrointestinal hemorrhage, hyperthyroidism enteropathy, diabetic enteropathy, etc.; if accompanied by loud, high-pitched, or even clanking sound or metal collision tone sound, it is called hyperactive bowel sounds, mostly seen in mechanical intestinal obstruction. When the bowel sounds are significantly reduced to below normal, or only heard once in several minutes, it is called diminished bowel sounds, mostly seen in senile or habitual constipation, peritonitis, hypokalemia, gastrointestinal hypofunction, hypothyroidism enteropathy, etc.; if the bowel sounds are still not heard for 3-5 minutes, it is called disappearance of bowel sounds, mostly seen in paralytic intestinal obstruction. In the process of treatment, if the symptoms have disappeared, some patients can still hear their intestines “singing” or farting more, it may be that the function of the intestines has returned to normal, but the patient can still perceive this sound due to excessive attention. If a patient with constipation has more bowel “singing” after treatment, it means that the bowel has started to move, which is a positive development. If a patient has a fart that stinks, he or she may be having trouble digesting protein. What should I do for this type of patient? Since the patient has a good appetite but has wasting, it is better to check the stool routine and occult blood test, make a blood test of thyroid hormone and blood sugar level, and do a colonoscopy if possible. If all the above tests are normal, a gastrointestinal smooth muscle selective calcium channel blocker, pivibromine (trade name: Desutex), can be used for treatment, the usage is 50mg/dose, 3 times/day; or Otibromine (trade name: Spamin) 40mg/dose, 3 times/day; Trimebutine (trade name: Shuriken) 100mg/dose, 3 times a day. A general course of treatment for 6-8 weeks can effectively relieve the symptoms of abdominal pain, bloating and diarrhea. In case of recurrence, the drug can be reapplied. At the beginning of treatment, if abdominal pain is obvious, short-term (1-2 weeks) auxiliary application of anticholinergic drugs (such as belladonna combination, etc.); if diarrhea is more serious, application of montelukast (Simethicone antidiarrheal powder), 1 sachet/time, 2-3 times/day, intestinal microecological preparations: such as bifidobacterium preparations (gold bifidum), 2 tablets/time, 3 times/day, can quickly break down lactose and assist digestion and absorption, and can inhibit a variety of intestinal pathogenic bacteria ; and short-term (3-7 days) application of methotrexate 0.2/time, 3 times/day. If accompanied by insomnia and anxiety, a small amount of anti-anxiety and depression medication can be given appropriately, such as Jaladyl 0.4mg, half an hour before bedtime, Dextran 1 capsule/time, 1 time/day, and venlafaxine 37.5mg/time, 1 time/day. In general, treatment varies from person to person and condition to condition. Why do these patients’ symptoms worsen after every milk drink? This is because the intestinal tract of this group of patients is intolerant to milk, probably due to the lack of lactase in the intestine, which cannot break down the lactose in milk, and is related to the tendency of milk to produce gas. In the UK, the intolerant foods for patients with irritable bowel syndrome are, in order, wheat, dairy products, coffee, etc. Therefore, these patients should pay attention to some of the following issues in their life and diet: after talking with the doctor and relevant examinations, they should be completely relieved of their ideological concerns that the disease is not cancerous and can be cured, and improve their confidence in treatment; establish good interpersonal social relationships and living habits. Diet should avoid foods that induce symptoms, which varies from person to person. In general, it is advisable to avoid gas-producing (such as dairy products, soybeans, potatoes, cabbage, etc.), frozen or irritating foods or beverages or strong-tasting condiments; people with diarrhea should have a low-protein, low-fat, low- or no-lactose diet and eat less high-fiber foods. Use certain drugs with caution, because many drugs can cause symptoms similar to this disease, such as non-steroidal anti-inflammatory analgesics (Fenbid, anti-inflammatory pain, etc.); some drugs can induce irritable bowel syndrome, such as some antacids, some antibiotics, beta-blockers (such as Tipsan, Betaloc, etc.), some information about abdominal massage techniques can help relieve symptoms: loose stools, can be slowly counterclockwise massage The umbilical cord, 10 minutes each time, constipation, can slowly massage the umbilical cord clockwise, 10 minutes each time, the patient may wish to try. At the same time, such patients should pay attention to diet when traveling outside, generally do not try new food (is not usually eaten food), even if you want to eat, but also as little as possible, should choose the usual eaten and will not cause abdominal discomfort food, then you can safely spend, and to carry the above-mentioned drugs, in case necessary to take.