How Effective Are Probiotics for IBS?

IBS, Irritable Bowel Syndrome (IBS), is a common functional bowel disease, with abdominal pain or abdominal discomfort as the main symptoms, which can be improved after defecation, often accompanied by changes in defecation habits, and a lack of explanation of symptoms Science and biochemistry abnormalities.

IBS

(Irritable bowel syndrome)

IBS, Irritable Bowel Syndrome (IBS), is a common functional bowel disease, with abdominal pain or abdominal discomfort as the main symptoms, which can be improved after defecation, often accompanied by changes in defecation habits, and a lack of explanation of symptoms Science and biochemistry abnormalities.

Epidemiological studies around the world have reported that IBS is a worldwide disease. The prevalence of the population in Western countries ranges from 10% to 20%. An epidemiological survey according to Rome standards in our country shows that the prevalence of IBS in the community population is 5.7%, of which 22% have seen the IBS symptoms.

Western Medicine Name

Irritable bowel syndrome

English name

irritable bowel syndrome, IBS

The main symptoms

Abdominal pain, bloating, diarrhea, constipation

English abbreviation

IBS

The general cause is the result of the interaction between the body's stress response and psychological factors. Different individuals may be involved in genetic, environmental, psychological, social and gastrointestinal infections, leading to changes in gastrointestinal motility and disturbances in the brain-gut axis interaction. , Autonomic and hormonal changes, and patients with mental disorders (such as panic, anxiety, post-traumatic stress disorder, etc.), sleep disorders and psychological coping disorders, stress life events can often cause symptoms to worsen, but for The exact link between psychological factors and IBS is not yet clear. Studies have found that one third of IBS patients have a history of gastrointestinal infections. At home and abroad, the impact of psychosocial factors on the pathogenesis of IBS has been emphasized. More attention has been paid to the role of neuropeptides and related receptor functions in the pathogenesis of IBS. People have strengthened the research on the relationship between IBS and inflammatory bowel disease (IBD), and a few scholars even think that IBS is the early manifestation of IBD.

Symptoms are still used for clinical diagnosis and research.

Irritable bowel syndrome

1) The general standard of IBS: In the last 3 months, recurrent abdominal pain or discomfort appears at least 3 days a month, and has 2 or more of the following:

Symptoms improved after defecation.

With the change of defecation frequency.

accompanied by changes in stool characteristics.

The diagnostic criteria are based on the presence of symptoms within at least 6 months before diagnosis and persistence in the last 3 months. The frequency of pain (discomfort) symptoms during the observation period is at least 2 days a week.

2) The general symptoms of IBS support diagnosis:

Abnormal defecation frequency: a. 3 defecations per week or b.> 3 defecations per day.

Abnormal stool characteristics: c. Blocky stool / hard stool or d. Loose stool / dilute water stool

laborious defecation.

Urgency or defecation.

Drain the mucus.

abdominal distension.

3) IBS subtypes are divided into the following subtypes based on the characteristics of stool:

IBS constipation (IBS-C): Hard stool or blocky stool defecation ratio 25%, thin stool (paste stool) or watery stool defecation ratio <25%.

IBS diarrhea type (IBS-D): The proportion of loose stools (paste-like stools) or watery stools is 25%, and the proportion of hard or blocky stools is <25%.

Mixed IBS (IBS-M): The rate of defecation of hard or blocky stools is> 25%, and the proportion of defecation (pastey stools) or watery stools is 25%.

Uncertain IBS (IBS-U): The traits of feces do not meet any of the above IBS-C, D, and M standards.

In addition to paying attention to fecal traits during IBS typing, patients should also pay attention to symptoms such as laborious defecation, urgency, and inability to defecate. In most cases, fecal traits (from dilute watery stools to indurated stools) can reflect the intestinal tract. Transit time.

The main points that have been emphasized in the diagnosis are: the abdominal pain is relieved after defecation, and the number of stools is accompanied by abdominal pain

The diseases that need to be differentially diagnosed with IBS are mainly inflammatory bowel disease and colorectal tumors. Attention should also be paid to the identification of IBS · D and lactose intolerance, intestinal bacterial overgrowth, and parasitic infection.

Here we emphasize individualized comprehensive treatment, that is, it should include psycho-psychological and behavioral intervention treatment, diet adjustment and drug treatment. Patients' treatment methods and choice of drugs should be treated differently from person to person. There are three types of recommendations for the treatment of the IBS expert group in Rome III:

1.Psychotherapy

Symptoms are severe and stubborn, and those who have failed general treatment and medication should consider psychobehavioral therapy. Including psychotherapy, cognitive therapy, hypnosis therapy, biofeedback, etc.

2. Diet adjustment

Poor eating habits and diet can exacerbate the symptoms of IBS. Therefore, a healthy, balanced diet can help reduce the symptoms of gastrointestinal disorders in patients. Patients with IBS should avoid:

Overeating;

heavy drinking;

Caffeine;

high-fat diet;

Some vegetables with "gas production" effect;

Refined food and artificial food (constipation), sorbitol and fructose (diarrhea);

food intolerance (varies from individual to individual).

Increasing dietary fiber is mainly used in IBS patients with constipation. The method of increasing fiber intake should be individualized.

3. Drug treatment

Mainly for patients with significant symptoms, due to the complex and changeable symptoms of IBS patients and the complex relationship with the central and enteric nervous system, the drugs have limitations in effectiveness and safety, which can only work to a certain extent. Desote is the most popular gastrointestinal selective calcium antagonist in various types of smooth muscle antispasmodics. It is used in dozens of countries; tegaserod (introduced with the Rome III standard) has been extremely popular and its effectiveness And safety limit its use; in recent years, great attention has been paid to probiotic treatment, and drugs with visceral sensitivity (visceral sensitivity to neuromodulation at all levels) have been the focus of development. Cyclic and serotonin reuptake inhibitors in antidepressants have a certain regulation of visceral sensitivity, and their long-term treatment is still emphasized, especially those with more persistent symptoms.

Other non-pharmacological treatments include psychological specialty treatment, hypnosis treatment, biofeedback treatment, behavioral treatment, etc. Although these are not currently recommended by the IBS expert group in Rome III, they overlap with the above and also show a certain effect. further research.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease, with abdominal pain or abdominal discomfort as the main symptoms, which can be improved after defecation, often accompanied by changes in bowel habits and stool characteristics, constipation and diarrhea can alternate, but Lack of morphological and biochemical abnormalities that explain the symptoms. In the past it was called "spastic colitis", "mucinous colitis" and "unstable colitis". The majority of patients with this disease are young and middle-aged 20-40 years old, and more common in women. In terms of drug treatment, western medicine has no ideal medicine.

The prevalence of irritable bowel syndrome in China is about 10% -20%, and the patients are mainly young and middle-aged. The exact pathogenic mechanism is still unclear, but psychological factors are important factors leading to the onset of the disease, which seriously affect the quality of life of patients. Patients should seek medical treatment in a timely manner, and antispasmodics can be selected under the guidance of a doctor to relieve the corresponding symptoms; and antidiarrheals / diarrheals can correspondingly improve the symptoms of diarrhea / constipation; or probiotics can be used to adjust the beneficial intestinal flora to reduce the symptoms of abdominal discomfort. Only by adjusting the diet structure and improving the emotional state can the goal of gradual recovery be achieved. ^[1]