【Local Medical】Recurrent abdominal pain and diarrhea may cause irritable bowel syndrome to come to your door

【Local Medical】Recurrent abdominal pain and diarrhea may cause irritable bowel syndrome to come to your door


Text◆Chen Xiaoquan

Irritable bowel syndrome not only affects people’s quality of life, but also reduces work efficiency and causes tremendous stress.

Clinically, if a patient repeatedly experiences abdominal pain and discomfort for at least 3 days a month, he or she may suffer from irritable bowel syndrome.

(Kuala Lumpur News) Irritable Bowel Syndrome (IBS, referred to as irritable bowel syndrome) is mainly divided into two categories, namely constipation type and diarrhea type, and both have comprehensive symptoms of alternating flatulence and abdominal pain.

Irritable bowel syndrome does not cause structural changes and does not endanger the patient’s life. It is a purely functional syndrome. For example, fast operation of the large intestine causes diarrhea, and slow operation of the large intestine causes constipation or flatulence. These imbalances in large intestine function can lead to abdominal pain. or throbbing symptoms.

Senior Consultant, Hepatogastroenterology
Dr. Liu Hongrui
(Dr Alex Leow Hwong Ruey)

15 out of 100 people have irritable bowel syndrome

Dr. Alex Leow Hwong Ruey, senior consultant of the Department of Hepatoenterology and Gastroenterology, revealed that the incidence rate among Malaysians is about 14% to 15%, and 15 out of 100 people suffer from irritable bowel syndrome, especially young people. The age of onset is between 5 and 40 years old. But relatively speaking, people aged 40 or above are the risk group for colorectal cancer.

“In terms of factors that induce irritable bowel syndrome, the main factors include eating habits, daily life and mental stress. Studies have found that irritable bowel syndrome has genetic signs, so it can be diagnosed through family history.”

He said that in terms of dietary factors, it depends on whether the irritable bowel syndrome is constipation or diarrhea. If it is constipation, the patient may eat less fiber foods. However, many people think that as long as they eat more fiber foods, it will be fine. In fact, this may not be the case. Eating too much fiber can cause bloating, which can indirectly aggravate the symptoms of irritable bowel syndrome.

Therefore, the most important thing about nutrient intake is moderation. If diarrhea is induced by diet, the patient may have eaten irritating foods, such as coffee, strong tea, wine, hot and sour foods, etc.

“Since irritable bowel syndrome is most common among young people, especially office workers or students, most of the triggering factors are work or academic pressure. When this group has constipation, diarrhea, flatulence or abdominal pain, the most important thing is to The first thing is to rule out the possibility of colorectal cancer. If it is not colorectal cancer, it is usually irritable bowel syndrome. However, if the diarrhea problem persists, we must rule out the possibility of gastroenteritis.”

The flatulence caused by irritable bowel syndrome is related to fiber. Scientific research shows that fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) are a special type of carbohydrates and sugar alcohols. , this kind of food is generally not easy to be absorbed by the intestines. After staying, it will be fermented by intestinal bacteria and produce gas, causing abdominal distension.

Eat less high-FODMAP foods

He said that although garlic, green onions, broccoli, avocados, almonds, apples, etc. are all healthy foods, they contain high levels of FODMAPs and eating too much can easily cause bloating. Therefore, if patients with irritable bowel syndrome are troubled by flatulence, it is recommended to eat less high-FODMAP foods.

In addition to diet and stress, food poisoning and taking antibiotics are closely related to irritable bowel syndrome. The microbiota in our intestines plays a crucial role in maintaining the beauty of the intestinal environment. This is like flowers, trees, and birds singing in nature. But once a fire occurs, the ecological environment will be severely damaged, and food poisoning or antibiotics will This ‘fire’. Food poisoning and antibiotics can change the microbiome in the intestines and cause diarrhea.

He said that no matter during any festive period, everyone will inevitably indulge themselves, overeat, stay up all night, and not want to move much, which aggravates the occurrence of irritable bowel syndrome. The last thing to note is that if the diet is not taken care of properly, resulting in food poisoning, irritable bowel syndrome will worsen again, so the festive season is also a good time for irritable bowel syndrome.

“Constipation, diarrhea, and abdominal pain can also occur in enteritis or colorectal cancer. Therefore, in clinical practice, doctors will ask patients whether there are any signs of danger, especially blood in the stool and black stool. Irritable bowel syndrome is unlikely to have bloody stool. , if the stool is black, that is, the blood is oxidized in the stool, and once there is bloody or black stool, the patient may suffer from colorectal cancer. In addition, inflammatory bowel disease (IBD) also has symptoms of bloody stool.”

Young people should not take it lightly

Recently, there is a quantitative test for fecal calprotectin. As long as the test index is high, the possibility of the patient having irritable bowel syndrome can be ruled out. Calprotectin is a calcium-binding protein secreted by neutrophils in our body. If there is inflammation in the large intestine, white blood cells will secrete calprotectin and accumulate in the feces. As long as the detection index is high, it means that the large intestine is inflamed. . The patient simply collects stool, takes it to a clinic, and asks the doctor to do a calprotectin test.

He emphasized that irritable bowel syndrome does not make people suddenly lose weight. If a patient loses weight rapidly and has a loss of appetite, it may be caused by other diseases. The most important point is family history. If there is a history of colorectal cancer in the family, more detailed and accurate diagnosis is required, especially for the elderly (over 50 years old). Once the elderly have a problem of rapid weight loss, we need to take the worst. Think about it.

Even young people should not take it lightly. Liao Hongrui once treated a young patient who was initially diagnosed with irritable bowel syndrome. Later, a colonoscopy was performed and it was found that there was a tumor in the intestine. However, the probability of tumors in young people is lower.

“According to Rome IV criteria,

The patient has had abdominal pain or other symptoms at least 1 day per week in the past 3 months.

Then you must consider whether you have irritable bowel syndrome.

However, if a patient has symptoms for more than 2 weeks,

I would recommend that this patient get tested,

There is no need to wait until 3 months, the most important thing is to rule out the possibility of colorectal cancer or other major diseases. “

Fortunately, irritable bowel syndrome will not cause cancer or cause other diseases, nor will it have long-term sequelae. However, other diseases may induce irritable bowel syndrome, such as IBD, which may induce this disease after treatment. There are also symptoms of irritable bowel syndrome that change due to seasonality. For example, a patient with irritable bowel syndrome may be constipated in the first 3 months. At this time, the doctor will prescribe laxatives to relieve the symptoms, but then the symptoms will switch to Diarrhea type, which is why irritable bowel syndrome is difficult to cure, and it will also seriously interfere with the mental state and mood of patients with irritable bowel syndrome.

Farting all the time is a problem with the large intestine

In addition, patients with irritable bowel syndrome who experience flatulence often think it is caused by stomach problems. However, if they keep farting, it is actually caused by a problem in the large intestine; if they keep burping, it is a stomach problem.

More complex forms of irritable bowel syndrome can be complicated by other diseases, and most patients with irritable bowel syndrome will have symptoms of indigestion. Such patients have weak gastric function and also have gastric acid problems, resulting in frequent abdominal distension. Treatment of such patients cannot rely on one drug alone, and patients also need to take stomach medicine.

“This is also why some doctors fail to achieve the expected results when treating irritable bowel syndrome. This is because they do not carefully detect the patient’s symptoms, so treating irritable bowel syndrome takes a long time to find out the cause and medical history of the patient. The typical treatment period for irritable bowel syndrome is four to six months.”

“Every time I tell patients with irritable bowel syndrome, drugs can only treat the symptoms but not the root cause. They only relieve the symptoms. Ultimately, they still need to change their eating habits, exercise and reduce stress. These are the key to treating irritable bowel syndrome. The best ‘drug’. If the patient is under too much mental stress but does not find a way to reduce the stress, the symptoms of irritable bowel syndrome will come back again and again, and the treatment period will be prolonged.

Research shows that people who lack exercise will have intestinal problems. In fact, exercise can promote the body’s metabolism and ensure the efficient operation of the intestines, reducing the chances of constipation and diarrhea. Patients can also reduce stress through activities, make their lives more active, and feel cheerful both physically and mentally.

Diagnosing irritable bowel syndrome from medical history when symptoms overlap with other illnesses

Treating irritable bowel syndrome is quite tricky, and medical history is the most important part. Because the symptoms of irritable bowel syndrome can overlap with other diseases, doctors must get a good diagnosis from the medical history.

Second, it is necessary to rule out whether the patient suffers from serious or dangerous diseases. If there are symptoms in the intestinal tract, the elderly should not think that it is irritable bowel syndrome. It is best to detect it as soon as possible.

Liao Hongrui suggested that patients with irritable bowel syndrome should eat small meals frequently and enjoy delicious food as long as they do not overeat. If the patient knows that certain foods will affect the body and insists on eating forcefully, then there will be consequences at your own risk, but these effects will probably last for a period of time. About two days.

Take fiber or laxatives for constipation

For the treatment of irritable bowel syndrome caused by flatulence, first do not consume any high-FODMAP foods. After the flatulence symptoms are relieved, try which FODMAP foods cause you the flatulence symptoms one by one. For example, if you are an avocado lover, stop eating avocados for two weeks, wait until the symptoms of bloating disappear, and then try avocados to see if avocados are causing your bloating.

Some people will ask: “I had no problem eating this food before, why do I have these symptoms now?” He said that this is because of changes in the intestinal microbiota. Maybe the patient had food poisoning before, so the microbiota in the intestines It has not yet been reestablished, but it generally only takes about 6 months to restore the balance of the intestinal microbiota.

As for the drug treatment, it depends on the type of irritable bowel syndrome. If you have constipation, take fiber or laxatives, and eat more fiber fruits or foods, such as papaya, vegetables, etc.; if you have diarrhea, take probiotics. In fact, probiotics have a great effect on diarrhea. Some medical studies have pointed out that probiotics have a great effect on intestinal health. As for supplementing probiotics, some people think that taking more probiotics will help people with poor stomachs, but in fact it doesn’t help much. Some patients with irritable bowel syndrome have too many bad microbiota in their intestines. These patients can take antibiotics to ‘reset’ their intestines and relieve diarrhea symptoms.

Abdominal pain requires mebeverine

If you have abdominal pain, you need to take mebeverine, which is a painkiller to relieve abdominal cramping symptoms. However, unlike probiotics and laxatives, it requires a doctor’s prescription.

However, some patients with irritable bowel syndrome caused by excessive mental stress need to take antidepressant drugs, but these drugs are not the mainstream drugs for the treatment of irritable bowel syndrome.

“Research indicates that,

The first specialist that patients with depression should see is not psychiatry, but gastroenterology.

Just because these patients have gastrointestinal discomfort,

For example, gastric acid problems, irritable bowel problems, etc.

Irritable bowel syndrome is the most common clinical manifestation among patients with depression.

Therefore, whenever the doctor consults,

It is also necessary to observe the patient’s mental state,

If the patient is too nervous and stressed,

You need to start with mental pressure.

Once a patient is diagnosed with depression, a referral to a psychiatrist is necessary. “



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