Some people have the concept that bowel movements equal detoxification. If it’s true, then having regular bowel movements should make you feel good, right? Some people suffers from bloated tummy despite having daily bowel movements, why is that? The most common reason is irritable bowel syndrome, generally known as “gut -sensitivity.” Most patients develop symptoms in their twenties. Cause of irritable bowel syndrome is not fully understood, it is believed to be related to emotional stress, sleeping disorders and eating habits and so on. During exacerbation, symptoms such as tummy pain, bloating or discomfort are common, and usually partially relived by toileting. Both diarrhea and constipation can occur, stool consistency can be hard or watery, and mucus discharge may present. Of course, most people occasionally have the above problems, but if the symptoms are frequent or affecting their social life, then he/she may be suffering from irritable bowel syndrome. Severely affected patients will have fear of going out or socializing for fear of needing a bathroom; incontinence is seen in extreme situation.
Irritable bowel syndrome has no specific medical test; making the diagnosis relies solely on symptoms. Doctors usually recommend taking stool samples for laboratory testing and endoscopic investigations. Endoscopy can eliminate some of the more serious diseases such as colorectal cancer, inflammatory bowel diseases (such as Crohn’s disease and ulcerative colitis), and infectious bowel diseases (such as tuberculosis). If all tests are normal, but symptoms persist, the chance of irritable bowel syndrome is likely.
Patients should pay attention to diet and avoid high FODMAP diet. High FODMAP containing food include fructose ( such as apples, pears, mango , watermelon ) , lactose ( such as milk , cheese, soft cheese ) , oligosaccharides ( such as the West orchids, onions, wheat ) and polyols (such as a sugar substitute for chewing gum and sweetener sorbitol and xylitol). Probiotics is also helpful in some patients.
According symptoms of this disease can be divided into (1 ) diarrhea type , ( 2 ) constipation type , ( 3 ) mixed type , and ( 4 ) non-categorical type. For each particular patient, his/her symptoms and hence classification may also change in time. Irritable bowel syndrome has no “cure”, the main goal of treatment is to ease symptoms. Doctors will prescribe medications based on symptoms and the severity of the patient. Patients with mood disorders should receive appropriate mental health treatment. When the mental health is well, gut symptoms may be improve.
Blog: dr-ernest.net
什麼是腸敏感?
有些人仕覺得大便暢通等於排毒。但如果日日都有排便，仍然腹部脹脹，又點解呢？最常見的原因就是腸易激综合症，一般人稱「腸敏感」。患者多於二十多歲時首次發病。醫學界對腸易激综合症的成因未完全明白，但相信與壓力過大，情緒緊張，睡眠失調和飲食習慣等有關。病發時會有腹痛，腹脹或腹部不適，而排便後會得到一定的紓緩。同時亦會有肚瀉或便秘，大便過硬或呈水狀，或大便時有黏液排出。當然一般人偶然也會有以上情況，但若症狀頻密或影響日常生活，便有可能是患了腸易激综合症。嚴重的患者會因為害怕需要找洗手間而減少外出和社交活動，甚至乎失禁。
腸易激綜合症沒有特定的確認檢查，只能倚靠病徵確診和分類。所以醫生一般會建議取大便樣本作化驗和內視鏡檢查。內視鏡檢查能夠排除一些更嚴重疾病如大腸癌，免疫系統性腸炎(如克隆氏症，潰瘍性腸炎)，和感染性腸炎(如過濾性病毒，肺癆菌)。如所有檢查結果正常，而病徵持續，很大機會是患上腸易激綜合症。
患者要注意飲食，避免高”腹鳴”食品 (FODMAP diet). 高腹鳴食品包括果糖(如蘋果，梨，芒果，西瓜)，乳糖(如牛奶，乳酪，軟芝士)，寡糖(如西蘭花，洋蔥，小麥)和多元醇(如用於香口膠和作代糖的甜味劑sorbitol和xylitol)。益生菌亦對一些患者有幫助。
根據病徵，此症可分為(1)肚瀉型，(2)便秘型，(3)混合型和(4)無法分類型。而患者亦可能隨時改變徵狀和類型。腸易激综合症並沒有根治的治療，治療的目的主要為緩和病徵。醫生會根據患者的病徵及嚴重程度選擇藥物。如患者有情緒病，亦應接受適當治療。當情緒病得到控制，腸胃症狀亦會紓緩。那就不需要想法子遮蓋脹起的腹部。
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