Study On The Relationship And Treatment Between Irritable Bowel Syndrome And Intestinal Microflora, Psychological Factors

Irritable bowel syndrome is the most common functional gastrointestinal disorder. The typical symptoms are abdominal pain, flatulence, and irregular bowel movement. Some studies reported that 10-20% of all adults have these symptoms, corresponding to about 25-50% of all patients who need gastroenterologist's help. Despite this high prevalence, the cause of IBS is unknown. Many factors are likely to give rise to symptoms like those of IBS e.g., food intake, disturbances in the intestinal bacterial flora, psychosomatic influences, changed motility in the colon. All these factors by themselves or in combination can exert an effect on the motor function of the GI tract.Using breath testing techniques, studies have demonstrated an association between small intestinal bacterial overgrowth(SIBO), and some IBS blamed all their bowel symptoms on an acute bout of gastroenteritis. Nayal et al demonstrated that IBS subjects treated with metronidazole were significantly better than placebo-treated patients, suggesting that bacteria may play a role in the symptoms of IBS.We know that IBS has also been considered as psychological disease, which was accompanied with 40-50% mental disorders. There were near 80% onset and recurring of IBS was due to psychological factors. The quality of life is more severe impairment in IBS. In these patients anti-depression agents may be helpful secondary medications to improve the mood and regulate the GI tract physiological response. The purpose of this study was to test whether intestinal flora and psychosomatic factor is associated with irritable bowel syndrome and whether treatment by probiotics and doxepin reduces their intestinal complaints.1. The relationship between irritable bowel syndrome and intestinal flora. METHODS: Eighty-six patients(M32, F53; age(45.31 11.72)) was received with Live Combined Bifidobacterium,Lactobacillus and Enterococcus Capsules 1260mg.d-1 t.i.d.x4wk. Syndrome scales was used to evaluate the efficacy in gastrointestinalsyndrome. Fecal flora was also measured before and after the treatment. Six bacteria were cultured and the colony forming unints were counted in stool. SPSS was used for data analysis. RESULTS: For treatment of irritable bowel syndrome, the effective rate of Live Combined Bifidobacterium,Lactobacillus and Enterococcus Capsules was 57% in second weeks, 74% in fourth weeks and 73% in sixth week. Single symptom was reduced, especially in abdominal pain and stool character. Patients with IBS had varying degrees of intestinal flora imbalances, shown by a decrease in the count of Bifidobacterium(8.90 1.46vs.9.17 1.28, p<0.05)and Lactobacillus(7.23 1.39vs.8.02 1.77, p<0.05); a increase in the count of bacteroides (10.92 0.60vs.l0.30 0.94,p< 0.05);clostridiu difficile colonitis(7.49 1.65vs.6.66 1.68, p<0.05) and enterococci (7.82 1.34vs.6.97 1.04, p<0.05). No difference between IBS and control group in the count of enterobacteriaceae(8.76 1.21vs.8.31 0.99, p>0.05). The probiotica containing Live Combined Bifidobacterium, Lactobacillus and Enterococcus could increase Bifidobacterium count( 9.04 0.99vs.l0.51 0.45, p <0.05) and Lactobacillus count(7.55 1.16vs.8.85 0.54, p<0.05); decrease bacteroides count (10.89 0.84vs.l0.12 0.74, p<0.05) and enterococci count(9.43 0.97vs. 7.20 1.15, p<0.05); No obvious changes in clostridium difficile colonitis and enterobacteriaceae (pX).05). CONCLUSION: The result of the study indicate that the administration of Live Combined Bifidobacterium,Lactobacillus and Enterococcus improved the symptom of IBS and there was a gradual increase of this effect. Thereafter conditions remained stable for 2wk. That improvement may be associated with alterations in gastrointestinal flora.2. The relationship between irritable bowel syndrome and psychosomatic factor. METHODS: One hundred and three patients were divided into two groups :doxepin group of seventy-one patients(M32, F39; age(46 13) a) was received with doxepin 25mg.d~1,qnx8wk. Placebo group of thirty-two patients(M18, F14;age(48 11)a) was received with creon-panc...