If you have stomachache and diarrhea all the time, it might be this disease!

Author: Shang Zhanmin, Chief Physician, Beijing Chaoyang Hospital (West Campus), Capital Medical University

Reviewer: Zhang Yu, researcher at Chinese Center for Disease Control and Prevention

After eating a few bites of chili peppers, I felt a stomachache and diarrhea;

I just drank a bag of milk and my stomach aches and I want to have diarrhea;

I just entered the air-conditioned room and my stomach ached and I wanted to have diarrhea;

If you often have stomach pain and diarrhea, it is very likely caused by irritable bowel syndrome.

1. What causes irritable bowel syndrome?

Irritable bowel syndrome is not caused by some organic lesions in the intestines themselves, but because the gastrointestinal tract is too sensitive to external stimuli, so the intestines are prone to "losing temper", and once they lose temper, they will have a series of clinical syndromes such as abdominal pain and diarrhea. This is also the most common cause of irritable bowel syndrome.

A related experiment has been conducted in which an air bag was placed in the rectum of patients with irritable bowel syndrome and normal people, and their different reactions were observed by pumping air into the rectum.

Patients with irritable bowel syndrome will feel uncomfortable after inflating a little, while normal people will not feel particularly uncomfortable even after inflating more. This shows that the intestinal sensation of patients with irritable bowel syndrome is in a highly sensitive state.

Figure 1 Original copyright image, no permission to reprint

The second is the mental factor. People who are under too much mental stress, anxious, or depressed are more likely to get irritable bowel syndrome. Or when there are some negative events, such as divorce, illness of relatives, or death of elders, these factors may trigger irritable bowel syndrome.

The third factor is intestinal infection. For example, if you have had acute gastroenteritis or bacillary dysentery before and it was not completely cured at the time, or there is a residual mild inflammatory reaction, which leaves a mark in the intestine, it is easy to make the intestine overly sensitive to external stimuli.

The fourth factor may be more common abroad, that is, family abuse in childhood, which causes certain stimulation to the brain's nervous system. Such children are more likely to develop irritable bowel syndrome when they grow up.

The fifth factor is eating too much fiber-rich food, or using bloating as a trigger, which can also lead to irritable bowel syndrome, but this factor is relatively rare.

2. What are the diagnostic criteria for irritable bowel syndrome?

The latest diagnostic criteria are recurrent abdominal pain, at least one day a week for three consecutive months, and two or more of the following:

First, this abdominal pain symptom is related to defecation;

Second, the frequency of bowel movements changes, such as too many or too few bowel movements. For example, more than three times a day is diarrhea, and less than three times a week is constipation.

Third, the stool characteristics change, the stool is too loose or too dry.

Before diagnosis, the relevant symptoms must have appeared for at least six months, and the symptoms in the last three months have been a stage of repeated recurrences, which is a relatively active stage. This is the latest diagnostic standard.

Irritable bowel syndrome is a functional disease, and generally some targeted examinations are required to rule out organic diseases.

Figure 2 Original copyright image, no permission to reprint

For a young person, if the disease recurs but there is no other special medical history, and some basic examinations, such as stool tests and blood tests, are normal and meet the above criteria, irritable bowel syndrome can be diagnosed.

For older people, such as those over 45 years old, or those with other warning symptoms such as anemia, weight loss, and severe abdominal pain at night, these patients may need to undergo colonoscopy, thyroid function tests, etc. in addition to stool tests and blood tests to rule out related organic diseases.

3. What should patients with irritable bowel syndrome pay attention to in their diet?

Dietary modification is very important for people with IBS.

First, pay attention to regularity and avoid overeating or skipping meals.

Second, avoid drinking alcohol and coffee, just try to avoid these stimulants.

Third, don't eat high-fat foods.

Fourth, eat less gas-producing foods, such as onions, cabbage, soy products, dairy products, soybeans, etc.

Fifth, patients with diarrhea should try to eat less high-fiber foods, but patients with constipation can eat them.

What is now advocated internationally is that patients with irritable bowel syndrome should pay attention to eating more "low FODMAP" foods.

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are difficult to digest in the gastrointestinal tract and will ferment to produce gas, causing gastrointestinal discomfort.

There are many common low FODMAP foods, such as fruits such as grapes, strawberries, bananas, kiwis, blueberries, oranges, etc.; vegetables such as cucumbers, tomatoes, bok choy, eggplant, lettuce, etc.; grains and beans such as rice, peanuts, green beans, etc.; and beverages such as lactose-free milk, lactose-free yogurt, and black tea.

The above foods are more suitable for patients with irritable bowel syndrome.