Functional gastrointestinal disease refers to patients with gastrointestinal symptoms, but no organic lesions in the gastrointestinal tract, so it is also called gastrointestinal neurosis. If further subdivided, those with gastric symptoms are called “non ulcerative dyspepsia”, and those with intestinal symptoms are called “irritable bowel syndrome”.
2、 What is the incidence of functional gastrointestinal disease
The disease has occurred worldwide. According to the literature, some developed countries have a higher incidence rate than China’s developing countries, for example, the incidence of women in the United States is 80%, mainly in knowledge women. According to expert estimates, about 1 / 3 of the general population (especially the middle-aged and elderly) have symptoms related to the disease.
3、 Under what circumstances is the disease prone to occur
The cause of the disease has not been fully clarified and may be related to one or more of the following factors.
Mental factors: most of them have anxiety, depression, restlessness, hypochondriasis and fear of cancer, and a few have mental symptoms such as insomnia, mental tension and exaggeration. Patients often make their illness very serious and worry all day, which affects their normal life, study and work. In addition, the disease is also related to mental stimulation or emotional fluctuation, such as sudden increase in workload, increased economic burden, fierce work competition, fast pace of life, less rest time, laid-off and unemployment, death of relatives, interpersonal tension and family disputes. Because mental factors can affect the movement, secretion and blood supply of gastrointestinal tract through autonomic nervous system, leading to the occurrence of this disease.
Heredity: the survey found that many people in the same family can suffer from this disease. It is common for parents and children to suffer from this disease, even for several generations.
Food: some people observed more than 20 kinds of food and found that acidic fruit, fresh salad, spices, wine, pepper and espresso were the causes of the disease.
4、 What will the disease show?
The main symptoms are stomach symptoms (more common in non ulcerative dyspepsia), mainly as follows:
Nervous vomiting: vomiting occurs suddenly after eating. There is no obvious nausea before vomiting. There is no pain during vomiting. The amount of vomiting is less (sometimes a lot). After vomiting, you can eat as usual without affecting appetite and intake. Therefore, despite long-term vomiting, patients rarely suffer from malnutrition.
Nervous belching: patients often have repeated and continuous belching (belching out a high-profile sound), which is mistaken for fullness and discomfort caused by gas in the stomach.
Anorexia nervosa: some people consciously diet for fear of getting fat or to lose weight. For a long time, they can have a sense of aversion to food, and the sense of hunger disappears. The clinical manifestations are less food intake, continuous weight loss, and cachexia in the late stage.
Other symptoms: intermittent upper abdominal pain, abdominal discomfort, nausea, acid reflux, heartburn, loss of appetite, postprandial abdominal distention, excessive farts, insomnia, fatigue, chest tightness, shortness of breath, palpitation, sweating of hands and feet, head and face fever and dizziness. Abdominal pain has nothing to do with diet, but has a close relationship with spirit and emotion.
The main symptoms are intestinal symptoms (more common in irritable bowel syndrome), which are mainly manifested as follows:
Abdominal pain type: most of them are flatulence pain or discomfort, but also temporary sharp pain, which can be relieved after defecation or exhaust.
Diarrhea and constipation type: the diarrhea type has a paste or thin stool and a large amount of mucus. It often occurs in the early morning or later in the middle of the night (commonly known as dawn diarrhea or five watch diarrhea). There is no abdominal pain during diarrhea. Constipation type can have no stool for several days, have spasmodic abdominal pain when defecating, and discharge hard stool like stone eggs or sheep dung balls. These two types of defecation often occur alternately.
Postprandial abdominal pain: abdominal pain occurs after eating, and defecation or exhaust cannot be relieved.
5、 How can this disease be diagnosed
At present, there is no specific diagnostic method, which is mainly based on the following data.
Symptoms: one or more of the above clinical symptoms; The basic condition of the whole body is good, no fever, and most of them have no weight loss.
Examination: gastroscopy, colonoscopy and barium radiography of the whole digestive tract showed no organic lesions of the gastrointestinal tract (intestinal spasm was occasionally seen in colonoscopy and barium radiography of the whole digestive tract); B-ultrasound, CT and other examinations of liver, gallbladder and pancreas were normal; Many times (at least 3 times) stool routine examination, culture and stool occult blood test were negative.
Previous history: no history of digestive tract diseases such as chronic gastritis, dysentery and intestinal parasites.
Mental state: there may be mental allergy, impatience, tension or depression.
In short, the disease is characterized by more subjective symptoms and less or no positive findings of objective examination.
6、 How to prevent this disease?
At present, there is no specific treatment for functional gastrointestinal diseases. The common prevention and treatment measures are:
Maintain a good psychological state: broad-minded, optimistic, cheerful and open-minded are the best measures to prevent the disease.
Treatment of psychological disorders: all negative psychological factors that may cause the disease should be avoided as far as possible, especially for those with phobia or cancer, to make the patients understand that the disease is a functional disease and will never endanger their lives, so as to eliminate their concerns and enhance their confidence in curing the disease.
Treatment of neurological disorders: tranquilizers can be given to people with mental tension, such as eszolam (formerly known as Shule anding), Baizi Yangxin pill and oryzanol; Amitriptyline and clomipramine can be used in patients with mental depression; For those with mental anxiety, take doxepin and alprazolam orally.
Treatment of gastrointestinal symptoms: atropine, anisodamine and belladonna can be used for those with abdominal pain, and dicycloethylamine or papaverine can be used if necessary; Compound diphenoxylate (phenethylpiperidine) and loperamide (Yimengting) were used for diarrhea; For constipation, use bisacoridine (constipation), phenolphthalein, Kaiselu, senna leaf and Maren Runchang pill, and eat more vegetables and fruits; Omeprazole (loserel) and nitidine can be used for heartburn and acid reflux; Domperidone and cisapride were used for abdominal distension; Metoclopramide (metoclopramide) and trichloro TERT butanol (chlorobutanol) were used for nausea and vomiting; For dyspepsia, pepsin mixture, trypsin, Xiangsha Yangwei pill, etc.
Dietary regulation: eat less and more meals, eat nutritious and digestible food, and avoid cold, overheated and irritating food (ginger, onion, garlic, pepper, mustard, etc.).
Traditional Chinese medicine treatment: mainly to soothe the liver and regulate qi, strengthen the spleen and remove dampness, and regulate the spleen and stomach. Chaihu Shugan powder, Sini Powder, Shenling Baizhu powder and Fuzi Lizhong pill can be used.