The intestines are apt to surge comprehensive disease IBS_ general knowledge

The intestines are apt to surge comprehensive disease IBS_ general knowledge
Definition:
The intestines are apt to defy syndrome to be a kind of chronic serial diseases, its characteristic is in case of not having the organic disease that can be detected, or discomfort and defecating and is used to the change that the belly pains. It can have two kinds of situations of diarrhoea and/or constipation, so are often divided into again according to the excrement and urine form: Suffer from diarrhoea for main fact type IBS (IBSD) , the constipation is main fact type IBS (IBSC) , IBSM (diarrhoea and constipation phenotype) And IBSA (suffer from diarrhoea with the replacing type of constipation) . It is a functional intestines and stomach disease (GI) A part.
Epidemiology and economics:
IBS morbidity in the general crowd in the whole world is 9%- 23%, and account for and get 40% that the disease expert of intestines and stomach diagnosed at most
Women take the majority, namely women male patient's proportion reaches 4:1 high in the clinical environment, and women's symptom is comparatively serious
Age is distributed not to be so obvious; Some research report morbidity is relatively high in young people, and drop with age, but other research reports do not have age difference
IBS exert a tremendous influence to the intersection of life and quality, consequence its high direct indirect the intersection of health care and cost (in high to up to 300 a hundred million dollars U.S.A.)
Pathologic physiology:
Pathologic physiology of IBS is not yet totally clear, but may be very complicated, is initiated by many kinds of factors.
One problem continue, take place on intestines wriggling unusual or feeling, punishing disorderly pain ' The sense of pain of viscera is allergic) Or the two.
There is mode that many kinds of unusual small intestines wriggle in IBS patient, but no wriggling disorder is the clear symptom of this syndrome, or the predictable relation that feels with pain exists.
By contrast, the increase that the intestine stimulate sensitiveness to pain is very obviously one of the main characteristics of IBS, though does not lie between the understanding of body and molecular mechanism to its position of anatomy, physiology disorder, cell completely. Still have dispute sense of pain irritated to come from central nervous system mainly at present, ' At the beginning at least) From perimeter ' Infection) The factor is touched off [it is the sensitization of peripheral nervous system at first, then the sensitization of nerve centre ].
The function that heredity is inclined to still has objection.
*In the particular member that IBS pains the pathogenesis may involve, 5 hydroxy color amine (5HT) Concern that get, at most, important factor wriggle, reflect normally intestine, it, and but and the receptor sensitization that the viscera pain helps the electric potential family V of instantaneous receptor to receive the body 1 (TRPV1) Contribute.
Diagnostic standard:
The diagnosis of IBS was carried out in the Rome III standard * by the base at present, namely
Or discomfort that the belly breaking out repeatedly pains, have 3 days per month at least within recent 3 months, and it is following to follow 2 kinds or more symptoms:
Improving after having an ease constipation,
The frequency is changed following defecating while breaking out, and
Accompany by the stool form to change while breaking out ' Appearance of the excrement and urine)
*As to begin until month by symptom 6 pieces at least by diagnosis,according to after March carry out by standard
Alarm symptom ( For example the weight is reduced, fever, rectum bleeding, seborrhea, lactose gluten are not tolerated) Show that structural disease may take place, such as cancer of colon, intestinal inflammation, malnutritive (such as stomatitis diarrhoea) ,But might not get rid of the diagnosis of IBS.
Clinical feature and instrument are checked:
Outbreak of IBS infect usually and diet, life style change and the intersection of psychological pressure and function of intestines and stomach taken place to continue take place disorderlily suddenly [compare with healthy individual, popular intensity that IBS patient is neutral, human body and emotion maltreat is higher ].
Spontaneous pain describe as angina, the intersection of belly and the intersection of pain and sense, severity its from slightly, get serious, continuation vary by intermission. It can take a favorable turn because take food and happen and had an ease constipation suddenly. Unless at women at patient, disease influenced by menstrual cycle,and before passing through with in aggravate. The belly pains in the area and generally increases with development of disease. Belly pain rotate by small intestine too Operate and bring out with the endoscope.
The clinical symptom that the belly pains and follows is as follows, tired and muscle, and joint pain and the intersection of pelvis and pain, headache, sleep, the intersection of sexual life and disorder, emotion lack proper care and urine worried
Compared with general crowd, IBS patient's more common clinical symptom (complication) As follows,
Insane ' The intensity prevails: In IBS patient 40%90%)
Fibrous myalgia and syndrome ' The intensity prevails: In IBS women patient 31.6%)
Break out repeatedly chronic the intersection of pelvis and pain (prevailing intensity of menstruation: In IBS women patient 50%)
Chronic fatigue syndrome, among quality cystitis, it is dorsal pain, temple lower jaw joint disorder syndrome, have a headache
IBS viscera and health of patient will to harmful to stimulate, produce, react unusually.
(1) In most cases is lower than intestine normal machinery and electricity to stimulate the threshold value of pain [The sense of pain of viscera is allergic ]
(2) Pain in the involving area on the belly of the body, the threshold value of normal pain less than and muscular tissue under the skin, cover; In the area of health that pain involves outside the district,
Lower than under the cover and normal the intersection of pain and threshold value of muscular tissue; The result of the skin has objection, may be normal, is higher than normally or lower than the threshold value of normal pain (heating, machinery, electricity are stimulated)
Formation of image of cranial nerve. The brain image of IBS patient indicates pain inhibits the activation of the return circuit from being influenced, including skin
Pontine return circuit, but limbs and the systematic return circuit of edge are activated and strengthened, may relate to the fact that pain is encouraged
Prognosis and treatment:
IBS will generally be sustained all one's life, though can control symptom slightly through treating.
The treatment is usually mixed. It involves: Diet factor ( Analyze conscientiously the possible food touches off things) ; Traditional pharmacology is therapeutic ' Including swelling pharmaceutical, town convulsion pharmaceutical, tricyclics, other spiritual medicines and laxative) , the plain medicine of activation serum [5HT3
The receptor resists pharmaceutical, 5HT4 receptor excitant, short of money association against pharmaceutical of 5HT4 excitant and 5HT3 ] short of moneyly; Antidepressants; Behavior and psychotherapy.
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