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Basic overof the irritable bowel syndrome (IBS) is a gastrointestinal disorder that is characterized by abdominal pain, bloating, constipation or diarrhea. Irritable bowel syndrome is a global problem, with the accelerated pace of life in recent years, changes in diet, neurological, mental, caused by infection factors in the incidence of irritable bowel syndrome on the rise. Quality of life and work cause some problems. In general, middle-aged high-risk population, including the incidence of women than men, mental than manual workers. Type of irritable bowel syndrome
Constipation: more frequently associated with periodic constipation and normal bowel movements alternating with white mucous stool often, the pain was strangulation-like, paroxysmal seizures, or persistent pain, after a bowel movement can be alleviated. Eating often trigger symptoms, can also occur bloating, nausea, indigestion and heartburn and other symptoms. Diarrhea: especially before eating and the beginning, or end of a sudden diarrhea. Diarrhea rarely at night, often pain, bloating and rectal urgency, fecal incontinence can also occur and so on. The main clinical symptom is abdominal pain and bowel habit and stool changes. First, almost all IBS patients have abdominal pain, varying degrees of abdominal pain. Location uncertain, the following common abdominal and left lower abdomen. More than relieved by defecation or exhaust. Second, the diarrhea usually about 3-5 times a day, a few severe attacks o


f up to ten times. Stool mostly thin paste, but also for forming soft stools or dilute water samples. More with mucus, some patients the amount of fecal matter less and a lot of mucus, but no pus and blood. Defecation did not interfere with sleep. Some patients with alternating diarrhea and constipation. Third, the constipation of constipation, dry manure, less, showing sheep or thin rods, the surface can be attached to mucus. Fourth, other gastrointestinal symptoms are usually associated with abdominal distension or bloating feeling, may have poor stool, defecation embarrassment. Fifth, a considerable part of patients with systemic symptoms may have insomnia, anxiety, depression, dizziness, headaches and other psychological symptoms. VI, no obvious signs of physical signs may be tenderness in the corresponding part of a light, some patients may reach sausage-like intestine, rectal examination can feel the anal spasm, tension high, can be tender. VII, classification can be divided according to the clinical features of diarrhea, constipation, diarrhea, constipation, and flatulence alternating type. IBS more than 20 to 30 years old at the occasion, causing symptoms of seizures, and repeated from time to time. Very little fat in the early evening. Symptoms common in awake, but rarely occur in sleeping patients. Symptoms can be due to stress or food intake into the trigger. IBS is characterized by pain relief for defecation, alternating bowel habits, bloating, stool with mucus and stool not the flu, there is the more symptoms, the greater the likelihood of suffering from IBS. Usually, the patient characteristics and location of abdominal pain , precipitating factors and defecation type is varied. common symptoms are common symptoms of change or deviation tips with simultaneous organic disease, should be thoroughly checked. IBS patients may also have extraintestinal symptoms (such as fibromyalgia, headache, dyspareunia, temporomandibular joint syndrome). IBS, there are two main clinical types. constipation-type IBS often constipation, but with different bowel habits. most of the patients had at least one or more parts of the colon pain, accompanied by constipation and more frequent periodic alternating normal stool. stools often containing clean or white mucus, pain, strangulation was like, paroxysmal attacks, or persistent pain, after a bowel movement can be alleviated. eating often trigger symptoms, can also occur bloating, flatulence, nausea, , indigestion and heartburn. diarrhea-IBS, particularly in the consumption of the beginning, during or just after a sudden diarrhea. night rarely diarrhea. often pain, bloating and rectal urgency, fecal incontinence can also occur. painless diarrhea is not typical, physicians should consider other diagnostic possibilities (such as indigestion, diarrhea permeability). pathologic etiology and pathogenesis of irritable bowel syndrome - etiology of irritable bowel syndrome (IBS), cause is not yet clear, can not find any anatomical reasons. Emotional factors, diet, drugs or hormones may precipitate or aggravate such a high tension of the gastrointestinal tract movement. Some patients with anxiety disorders; particular phobia, adult depression and somatic symptoms of the disorder. However, the stress and emotional distress are not always accompanied by the onset of symptoms and repeated. Some manifestations of IBS patients have acquired an abnormal pathological behavior, such as mental distress they tend to express complaints to the digestive tract, usually abdominal pain, physicians in the assessment of IBS, especially those with intractable symptoms when , should be aware of whether there can not solve their psychological problems, including sexual abuse and physical abuse. Irritable bowel syndrome - pathogenesis
First, the GI Dynamics abnormal physiological conditions, the colon is the basis of slow wave frequency electric rhythm 6 times / min, IBS with constipation, abdominal pain in 3 times / minute slow wave frequency was significantly increased. Second, abnormal visceral perception of rectal balloon inflation experiments show that, IBS patients with pain threshold was significantly lower than inflation control. Third, the psychological factors of psychological stress had a significant effect on gastrointestinal motility. A large number of survey, IBS patients have abnormal personality, anxiety and depression were significantly higher than the normal points, the frequency of stressful events was also higher than normal. Fourth, the other about 1 / 3 of patients with intolerance to certain foods which induce symptoms. IBS symptoms in some patients cured after intestinal infection. In recent years, studies have shown that the disease may be associated with a low degree of intestinal inflammation, such as mast cell degranulation, expression of inflammatory mediators and so on. Pathophysiology of IBS patients in the small intestine and sigmoid colon circular muscle and longitudinal muscle of the motility disorders are particularly sensitive. Proximal small intestine seems to be on the food and drugs have a high degree of parasympathetic responsiveness. In IBS patients with small intestinal transit changing, and intestinal transit time changes are usually
Not associated with symptoms. Sigmoid intraluminal pressure tests showed that functional constipation can occur in the pocket section of colon was highly reactive movement (such as contraction frequency and amplitude increase), on the contrary, the decreased diarrhea and motor function. IBS patients excessive secretion of mucus often happens, this has nothing to do with the mucosal injury, its causes are unknown, but cholinergic nerve activity and high levels of. and the intestine in patients with normal quantity and quality of the gas, they are very easy to feel the same pain. IBS's seems abnormal pain intensity by the intestinal smooth muscle contraction or expansion of the lumen of the small intestine caused by over-sensitive. may also gastrin and cholecystokinin on the high sensitivity. However, hormone fluctuations are not consistent with the clinical symptoms. uptake the increase in food calories EMG activity and can increase the amplitude and frequency of gastric activity. fat intake may cause a delayed peak power, a phenomenon more pronounced in IBS patients. the first days of menstruation may cause short-term rise of prostaglandin E2 high, resulting in increased pain and diarrhea. This is not caused by estrogen or progesterone, but due to the release of prostaglandins. diagnostic criteria for clinical diagnosis: in 1986 China established the reference standard for the clinical diagnosis of IBS: 1, abdominal pain, abdominal swelling, diarrhea or constipation chief complaint, associated with systemic neurologic symptoms (persistent or recurrent symptoms more than 3 months) 2, in general, good, no weight loss and fever, the system check found only 3 times stool and culture (at least 3 times) were negative, fecal occult blood test was negative 4, X-ray barium enema examination no positive findings, or colon irritation signs 5, colonoscopy showed movement in some patients with hyperthyroidism, no significant mucosal abnormalities, histology was normal 6, blood , urine normal, erythrocyte sedimentation rate 7, no diarrhea, schistosomiasis and other parasitic history, experimental treatment is invalid (note: refers to the treatment of metronidazole and disable test dairy products) meet the above standards, the general clinical diagnosis can be made. But pay attention to the performance with some hidden or atypical symptoms, identification of other diseases, the diagnosis of suspected can choose the further examination. Differential diagnosis: abdominal pain should identify the disease that causes abdominal pain. Diarrhea should identify the disease that causes diarrhea, lactose intolerance which common and difficult to distinguish. To cause constipation and constipation should be based disease identification, in which habitual constipation and constipation caused by adverse drug reactions common. More use of the current international Rome criteria, the latest standard of Rome 3, released in 2006. Diagnosis of IBS is based on stool characteristics, and characteristics of pain, time, and through physical examination and routine diagnostic tests established only after excluding other diseases. Standardized diagnostic criteria for IBS have been identified. Rome IBS criteria included abdominal pain relieved by defecation, stool frequency or nature of the changes, bloating, or mucus, diagnosis is the key to effective access to history, attention should be direct, non-mandatory for existing symptoms, medical history, past treatment history, family history, family relationships, drugs and diet to describe the history of the patient's interpretation of personal problems and overall emotional state of patients is equally important. physician-patient relationship is good or bad is to determine the key to diagnosis and treatment. In the physical examination, IBS patients showed a general health status, abdominal palpation can be tender, especially the left lower abdomen, and sometimes there may be tenderness of the sigmoid colon. All patients in need of rectal means the examination, pelvic examination should be made to women. Fecal occult blood test should be (the best three-day continuous). If there is no travel or related symptoms (such as fever, bloody diarrhea, severe diarrhea, acute onset) support, very few eggs or parasites in need of regular inspection or stool culture. Should be fiber rectal sigmoidoscopy, flexible sigmoidoscopy, and stretching into the air often induced intestinal spasm and pain. IBS patients often normal mucosa and blood vessels. In patients with chronic diarrhea, especially older women, mucosal biopsy to exclude microscopic colitis is, the there are two types: collagen colon type, three-color staining of submucosal collagen deposition; lymphocytic colitis , increase the number of mucosal lymphocytes. The average age of these patients is 60 to 65 years old, female common. With IBS the same as the performance of non-bloody watery diarrhea, can be diagnosed by rectal biopsy. Laboratory tests should include complete blood count; ESR; 6 or 12 biological spectrum, including serum amylase, urine analysis and determination of thyroid stimulating hormone. Patients should be based on the basic history, physical examination, age, selected for follow-up results of the assessment of abdominal ultrasonographic examination, barium enema, or colonoscopy esophagus stomach and duodenum. However, these checks only when the light and take less damage revealed only when an exception. should not rule out the diagnosis of IBS associated with the disease suspected. symptoms may indicate a change in the presence of another disease, such as pain, positioning, form and intensity of change, bowel habits, constipation or diarrhea, change in or vice versa, and the new symptoms or complaints (such as night diarrhea) may be clinically significant. Other symptoms include the need to examine mixed with fresh blood in the stool, weight loss, very severe abdominal pain or unusual abdominal swelling, steatorrhea was evil or white stool, fever or chills, persistent vomiting, vomiting blood, prompting patients to wake up from sleep symptoms (such as pain or anxious defecation) or persistent worsening symptoms in patients .40 years of age were more likely than younger mixed organic diseases. differential diagnosis of IBS may be confused with common diseases are: lactose intolerance, diverticular disease, "drug-induced diarrhea", biliary disease, laxative abuse, parasitic diseases, bacterial enteritis, eosinophilic gastritis or enteritis, microscopic (collagenous) colitis and early inflammatory bowel disease. inflammatory bowel disease patients showed a bimodal distribution of age, so the two groups of young and old the evaluation of patients with these conditions must be taken into account. more than 40 years of age, especially those without previous history of IBS symptoms, If there is change in bowel habits, must be excluded by colonoscopy colon polyps and tumors, in patients older than 60 years should consider the possibility of ischemic bowel disease. women pelvic examination will help rule out ovarian tumors and cysts or uterine fibroids, because the symptoms of these diseases can be similar with IBS. For patients with diarrhea, hyperthyroidism, carcinoid syndrome, medullary thyroid carcinoma, VIP tumors and Zollinger-Ellison comprehensive the possibility of levy should be considered. constipation in patients with and without anatomical lesions should be considered whether the thyroid dysfunction or the possibility of hyperparathyroidism. If the patient history and laboratory examinations showed malabsorption , absorption should be measured to exclude tropical sprue, celiac disease and Whipple disease, and finally, for all non-excessive force will be required in patients with chronic constipation should be considered in line other diseases (such as pelvic floor muscle incoordination). complication symptoms often appear or increase the number of stress and mental factors or states. Accompanied by some patients on a variety of gastrointestinal and extraintestinal symptoms of dysfunction. Mental disorder can be accompanied by psychological problems, such as depression, paranoia, tension, anxiety, hostility. 1 treatment of a general treatment: the establishment of good habits. Avoid eating foods elicit symptoms, vary, in general, gas production should avoid food such as dairy products, soybeans. High fiber foods help to improve constipation. For insomnia, anxiety may be appropriate to give sedatives. Second, drug treatment: 1. Gastrointestinal spasmolytic anticholinergic drugs can be used as short-term symptoms and symptomatic treatment of abdominal pain. Calcium channel blockers such as nifedipine for abdominal pain, diarrhea, a certain effect, pinaverium amine as the effect on gastrointestinal smooth muscle selective calcium channel blockers, so few side effects, usage for the 50mg, 3 times / day. 2. Antidiarrheal loperamide or diphenoxylate compound effective diarrhea for diarrhea heavier, but not long-term use. Adsorption of diarrhea in general should use antidiarrheal drugs such as Smecta, medicinal charcoal and so on. 3. Laxatives for constipation in patients with appropriate use of laxatives, but not long-term use. Hemicellulose or hydrophilic colloid, in the intestines are not digested and absorbed, and a strong hydrophilic, swelling in the intestinal lumen to increase moisture and volume of intestinal contents, help promote bowel movements, stool softening effect, is considered Ideally, the treatment of constipation IBS drug. Plantago agents such as Europe and other natural polymer polysaccharides. Recommendation: for patients with irritable bowel syndrome or long-term patients are willing to repeatedly, recommendations can be treated with traditional Chinese medicine, while paying attention to your diet habits, such as by taking the course "position blame John Ling antidiarrheal capsule" very good. 4. Antidepressants on abdominal pain, diarrhea and weight and the ineffective treatment of psychiatric symptoms may no trial. 5. Omeprazole enteric-coated tablets, oryzanol film, pudding trimetazidine maleate tablets, combination therapy. 6. Regulating drugs, such as intestinal flora Bifidobacterium, Lactobacillus and other agents, can correct intestinal flora, for abdominal distension, diarrhea effective. Promote gastrointestinal motility drugs such as cisapride help constipation improvement. 7. Motility two-way adjustment: pudding trimetazidine maleate tablets (Trimebutine), which ENS by acting on peripheral opioid receptors, directly on the gastrointestinal smooth muscle, the release of gastrointestinal peptides regulate stomach three ways intestinal motility. Third, the psychological and behavioral therapies, including psychotherapy, hypnosis, biofeedback therapy, foreign reports have a certain effect. Supportive and symptomatic treatment of sexual. Physicians compassionate understanding and guidance is very important. Physician must explain the nature of underlying diseases, and to convince the patient confirmed that no organic disease exists. It takes time to listen to patients tell and explain to them the normal intestinal physiology and intestinal stress the high sensitivity of food or drugs. These are the basis of interpretation that we try to re-establish normal bowel movement and choice of law appropriate to the patient's specific therapy. It should be emphasized IBS to continue treatment on the epidemic, long-term and needs. should be to seek, evaluate and treat psychological stress, anxiety and mood disorders. Regular physical activity can help relieve stress and promote bowel function, especially in patients with constipation. In general, it should return to normal diet. Bloating and flatulence in patients with or Eat or not eat beans, cabbage and other containing fermentable appropriate carbohydrate foods, eat apples, grapes, bananas, all kinds of nuts and raisins can also reduce the occurrence of flatulence. For patients with lactose intolerance should reduce the intake of milk or dairy products. intake of sorbitol, mannitol alcohol, fructose, or sorbitol and fructose can also be ingested bowel dysfunction. sorbitol and mannitol is a nutritious food for drug delivery or as artificial sweeteners, and fructose is fruit, berries and plants the basic ingredients. postprandial abdominal pain, patients can try low-fat high-protein diet. to increase dietary fiber beneficial for many IBS patients, especially patients with constipation. may give a small irritant foods such as bran, began each meal 15ml (1 spoon), and with the increase of fluid intake. Or take the European plantain hydrophilic liquid glue, each served with two glasses of hydration, this is often the intestines can be stable and have increased water volume effect. These agents help moisture retention within the intestinal tract, can prevent constipation. They can also reduce the colonic transit time, but also as a shock absorbent to prevent the wall between the spasms. adding a small amount of fiber hardened stool by absorbing water and may also have help to reduce diarrhea in IBS. However, the excessive application of fiber can cause bloating and diarrhea, so the fiber should be individualized application of the principle. anticholinergic drugs (such as hyoscyamine 0.125mg, 30 to 60 minutes before a meal) can be with fiber applications. do not advocate the use of anesthetics, sedatives, hypnosis, and other dependence-producing drugs. For patients with diarrhea, may be given before meals diphenoxylate 2.5 ~ 5mg (1 ~ 2 tablets) or loperamide 2 ~ 4mg (1 ~ 2 tablets). because of diarrhea can occur on the effect of tolerance, so I do not advocate long-term use of antidiarrheal drugs. antidepressants (such as off Jiabing imipramine, imipramine and amitriptyline day 50 ~ 100mg) of the two types of IBS patients have helped. In addition to constipation and diarrhea, other antidepressants can alleviate the abdominal pain and bloating. These drugs can be reduced from the intestinal tract of the spinal cord and cortical afferent nerve activity to alleviate the pain. Finally, with some aromatic oil (painkiller), to ease through the relaxation of smooth muscle spasm pain in some patients. In these patients, pepper oil is most commonly used preparations. TCM treatment according to the disease clinical manifestations, is the motherland medicine "abdominal pain", "constipation" and "Melancholia" category. the site from the disease, although disease in the colon, but with the liver, spleen, stomach and other organs dysfunction related. Cause of pathology can be summarized as: liver qi stagnation Erzhi emotional disorders, liver and spleen are not, and, causing poor air-intestinal tract, intestinal organs Secretary conduction loss; or falling due to the cold, weak spleen yang and kidney damage, Yang not very inviting in the virtual coke, to transport and disorders Erzhi diarrhea. In addition, the diet, Lao Juan and the cold temperature can affect internal organs dysfunction disorder occurs in this disease. Clinical application of TCM treatment can receive better results can be divided into the following three types of Treatment. Liver and spleen deficiency: Zheng Jian want to vent diarrhea, pain reduction after diarrhea, belching eat less, easily bored anger good heave a deep sigh, tongue is pink with thin white, thin veins string. Expelling Liver Spleen, Reinforcing qi. Pain Diarrhea side addition and subtraction selection, medical speculation TGP 20 ~ 30g, Atractylodes speculation, wind, Citrus, Citrus aurantium, Gallus gallus domesticus, wide wood each 10g, heterophylla 15g, Bupleurum, cicada, licorice all 6g. Spleen and kidney yang: Zheng Jian cold limbs, abdomen Leng Tong, loose stools thin, on line 3 to 4 times, or just before dawn or diarrhea, diarrhea after abdominal security, abdominal distension and anorexia, thermophilic fatigue, tongue pale tongue body fat mass, thin white fur, pulse. Expelling Warming spleen, thick intestinal diarrhea. Party election four gods Pill, medicinal Codonopsis 12 ~ 15g (or heterophylla 15 ~ 20g), baked nutmeg, psoralen, fried Atractylodes, myrobalan, Morinda the 10g, fried Baiyao, Coix seed 15 ~ 30g, ginger 6 ~ 10g, Baked Licorice, wood, Amomum the 6g. Yangming Hot Junction: Zheng Jian less secret knot stool, abdominal distension and pain, accompanied by dry mouth, irritability, red tongue, little coating or coating a small yellow-chun, pulse is taut string or light. Expelling Yin addition to heat, relax Tongfu. Party election by subtraction decoction, medicinal Rehmanniae, Scrophularia the 15 ~ 30g, citrus aurantium, Magnolia, rhubarb, Gardenia the 6 ~ 10g, betel nuts, almonds each 10g, Hemp seed 10 ~ 20g, Health licorice 6g. Prevention of irritable bowel syndrome is the most common gut functional diseases, etiology and pathogenesis is not clear, may be drugs, emotional stress, food intolerance, colonic motor dysfunction, intestinal dysfunction, and esophagus, gallbladder abnormalities and other factors, including changes in bowel function in irritable bowel syndrome have an important role in the pathogenesis. Variety of clinical manifestations, lack of specificity. Stool routine and culture, barium enema, colonoscopy and a series of test were not found in intestinal organic disease, pathological examination and no abnormalities, such as the exclusion of the malabsorption syndrome, schistosomiasis, intestinal cancer, ulcerative colon inflammation, Crohn's disease, lactase deficiency, gastrointestinal hormone tumors, endocrine diseases, pelvic diseases, organic diseases before making a diagnosis. Irritable bowel syndrome is a benign disease, does not endanger the health of normal life and a good prognosis, although a recurring problem, the appropriate treatment can be gradually improved or even disappear. For the patient complained of chronic intestinal cover new onset of malignant disease, should always be vigilant, be good at identifying the functional complaints in the early detection of organic diseases, and some of the necessary checks. In terms of treatment to relieve tension, eliminate the psychological burden of confidence is very important. Patterns of life, adequate sleep, exercise, improve physical fitness. Eat small meals, avoid hot spicy food and cold diet, smoking and drinking. Diarrhea residue easily digestible food for less appropriate; constipation than the water, it should be to develop regular bowel habits and to increase the number of food containing cellulose. The main medicines to symptomatic treatment, according to abdominal pain, bloating and bowel adjust their daily drug dosage, to avoid constipation using a variety of laxatives. Hot-water bottle placed in the abdomen, massages, solarium and warm water, such as physical therapy have a role in the spectrum. Irritable bowel syndrome (IBS) are functional gastrointestinal disorders, refers to a group including abdominal pain, abdominal distension, abnormal bowel habits and stool, mucous, persistent or intermittent seizures, but the lack of morphological and biochemical abnormalities can explain the syndrome information. In the thinking of many of the disease burden, emotional stress, anxiety, anger, depression and other disease factors. So to avoid mental stimulation to relieve tension, maintain an optimistic attitude is the key to preventing this disease. of suspected food intolerance, such as shrimp, crab, milk, peanuts, try not to eat spicy, frozen, cold greasy food, alcohol and tobacco should be taboo. Avoid laxatives and physical and chemical factors on the intestinal tract irritation. RDA, but the hunger and satiety, to develop good habits. appropriate to participate in sports activities, active exercise, to strengthen health and prevent diseases. How to Prevent Irritable Bowel Syndrome? For the prevention of irritable bowel syndrome, also divided into before and after they fell sick sick. Of disease prior to the prevention of irritable bowel syndrome: appropriate to participate in sports activities, active exercise, to strengthen health and prevent diseases. of suspected food intolerance, such as shrimp, crab, milk, peanuts, try not to eat spicy, frozen, cold greasy food, alcohol and tobacco should be taboo. Avoid laxatives and physical and chemical factors on the intestinal tract irritation. RDA, but the hunger and satiety, to develop good habits. more in the thinking of the disease burden, emotional stress, anxiety, anger, depression and other disease factors. So to avoid mental stimulation to relieve tension, maintain an optimistic attitude is the key to preventing this disease. After the illness has been the prevention of irritable bowel syndrome: Eat small meals often. Diarrhea patients should eat less residue, digestible, low fat, high protein food; constipation should eat more fiber vegetables, whole grains, etc., to establish regular bowel habits. Avoid eating too cold and spicy food. The disease usually do not need bed rest, encourage patients to work and rest, may participate in appropriate work to establish good habits. the spirit of care is very important in this disease, health care workers and their families must complement each other to lift the ideological concerns of patients, according to test results, so that patients understand the causes of the disease, nature and good prognosis, to relieve tension, build confidence to overcome the disease. The disease is generally not life-threatening. It is important that these symptoms in patients with chronic diseases, it is easy to cover up the new onset of intestinal malignancy. For this reason, doctors should always be vigilant, pay attention to the quality of concurrent control early detection of disease. In the treatment and prevention of irritable bowel syndrome, the need to pay attention to: diarrhea patients should preferably less digestible food residue; and constipation patients except the water, it should be to develop regular bowel habits and to increase the number of food containing cellulose. Health antidepressant treatment of irritable bowel syndrome Abstract Objective To evaluate the antidepressant paroxetine (Seroxat) on irritable bowel syndrome (IBS) associated with anxiety and (or) the treatment of depression. Methods 46 patients fulfilling Rome diagnostic criteria for IBS patients, with the Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale (HAMD) were to rate the patients emotional state; randomly divided into treatment group and control group, two psychological counseling in the treatment group given the same time, the treatment group was treated with Seroxat (U.S. SmithKline Beecham) 20mg / d; 8 weeks after the re-assessment of the scale, before and after treatment HAMA, HAMD. The results of antidepressant treatment HAMA, HAMD decreased significantly than before treatment, the difference was significant (P 0.05 ~ 0.0012.4 side effects of treatment group, there was no case of liver and renal function abnormalities, 1 case of insomnia, dry mouth in 1 case. 3 to discuss foreign scholars found that 54% to 100% of the IBS patients had psychiatric symptoms, including anxiety, depression more common. It is felt that IBS is a psychosomatic disease. The etiology, pathogenesis, has not been elucidated. There intestinal 5 - HT nervous system, brain-gut in the middle of a variety of neural synaptic activity after the loop, not only the direct control of gastrointestinal motility, but also by affecting the wall of neurofilament indirect effects of other gastrointestinal motility nerve [3]. Clouse RE found that antidepressants on IBS, the most effective for the treatment of IBS provides a new method of treatment [4]. Traditional tricyclic antidepressants in the treatment often causes tachycardia, hypotension, dry mouth, constipation, urinary retention, dizziness. In this paper, a new generation of antidepressant paroxetine (Seroxat) psychological counseling made a significant effect. Paroxetine is a highly selective 5 - HT reuptake inhibitors, norepinephrine and dopamine reuptake is minimal, compared with tricyclic antidepressants are less toxic and adverse reactions. The study found that use of paroxetine (Seroxat) in treatment of IBS, not only can improve patient psychiatric symptoms, and gastrointestinal symptoms of IBS to improve the effect is significant, especially abdominal pain significantly more improvement. The diseases easily confused with IBS to be the main identification of the following diseases: first, malabsorption syndrome: intrinsic often diarrhea, but stool and undigested food visible fat. Second, chronic colitis: are also frequent abdominal pain, diarrhea, mucous bloody but mainly seen in colon colonoscopy congestion and edema, erosion or ulceration. Third, chronic diarrhea: diarrhea with pus and blood will mainly be seen a lot of pus and blood stool ball, or see Shigella, Shigella can see the growth of stool culture. Fourth, Cronh disease: often anemia, fever, weakness and other systemic symptoms, colonoscopy, see the "linear ulcers" or mucosa showed "cobblestone" change. Irritable bowel syndrome (IBS) are functional gastrointestinal disorders, refers to a group including abdominal pain, abdominal distension, abnormal bowel habits and stool, mucous, persistent or intermittent seizures, but the lack of morphological and biochemical abnormalities can explain the syndrome information. Characterized by irritable bowel function of. Chronic colitis is a chronic, recurrent, multiple in colon, sigmoid colon and rectum to disease site. Means for various colorectal inflammatory bowel disease causes edema, ulceration, bleeding lesions. What is the difference between the two then it? Both have recurrent abdominal pain, diarrhea, mucous. Irritable bowel syndrome on the card, although a recurring problem, but generally will not affect the general situation; and chronic colitis is often associated with different programs weight loss, anemia and other systemic symptoms. Colon endoscopy, chronic colitis microscope, colon rough, easy bleeding, bloody discharge mucus adhesion, multiple erosions, ulcers, or diffuse mucosal edema, and even the formation of polyps. X-ray barium enema shows a narrowing and shortening changes in intestinal mucosa rough mess, intestinal polyps such as bags lost and false changes. The irritable bowel syndrome with only mild endoscopic mucosal edema, erosion and ulcer bleeding but no other changes. Mucosal biopsy is normal. X-ray barium enema no positive findings, or colon irritation phenomena. Irritable bowel syndrome psychological factors predisposing factors and autonomic nervous dysfunction. Abnormal intestinal smooth muscle reactivity, familial tendency, suggesting that genetic factors. eating too fine. Cellulose deficiency caused by intestinal smooth muscle dynamics change. irritation or infection of the intestinal changes of intestinal muscle responsiveness. Irritable bowel syndrome more common in young adults with non-ulcer dyspepsia with the common functional gastrointestinal disorders, the two can appear in the same patients. Irritable bowel syndrome diet principles 1 and avoid over-eating. Regular meals should be quantitative, so that it will not cause hunger and eat uncertain. Experts point out that regular and moderate diet is conducive to a balance of intestinal digestion and absorption, while the uncontrolled over-eating, especially eating and drinking, can lead to serious disorder of bowel function, inducing the disease in patients with irritable bowel syndrome recurrence or increased. Therefore, patients should pay special attention to diet and reasonable arrangements for three meals a day to prevent excessive food hazards. 2, to prevent heavy drinking. Alcohol can cause bowel movements and digestion and absorption dysfunction, increase abdominal distension, abdominal pain, heavy drinking can also stimulate the intestinal mucosa, reduce local resistance to damage caused by intestinal mucosa, increasing indigestion and diarrhea. Therefore, medical experts warned in patients with irritable bowel syndrome, must be completely alcohol, be sure to do not drink. 3, do not drink coffee. The gastrointestinal tract, the coffee is a stimulating drink, as alcohol can cause bowel movement and digestion dysfunction, increase abdominal distension, abdominal pain, so patients with irritable bowel syndrome is best to avoid drinking coffee . 4, do not eat high-fat diet. Irritable bowel syndrome diet to light, digestible and less greasy as the basic principle. High-fat diet under any circumstances can cause digestive dysfunction and increased flatulence symptoms, and easily induced constipation, so patients should limit fat intake, in particular, to strictly limit the intake of animal fat. 5, gas eat the food. Food into the intestinal gas production, after the decomposition of intestinal bacteria can produce large amounts of gas, causing expansion and intestinal peristalsis slowly, patients can cause flatulence, abdominal pain, constipation or diarrhea. Patterns of life, adequate sleep, exercise, improve physical fitness. Eat small meals, avoid hot spicy food and cold diet, smoking and drinking. For the prevention of irritable bowel syndrome, also divided into before and after they fell sick sick.


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