The Evaluation Of Gastrointestinal Symptoms And Psychological Factors And Therapeutic Effect In Irritable Bowel Syndrome

Background & aims: IBS comprises a group of functional bowel disorders in which abdominal discomfort or pain is associated with defecation or a change in bowel habit,and with features of disordered defecation. We try to find out the difference between different subgroup of IBS, such as gastrointestinal symptoms,clinical straits and the therapeutic effect after treatment. We also set out to identify polymorphisms of the serotonin transporter gene and to find out whether there was a relation between any such polymorphisms and the occurrence of IBS subgroup.Methods: The study group comprised 34 patients (16 cIBS, 18 dIBS) and 10 healthy controls. Patients completed the gastrointestinal symptomsquestionnaire ,SCL-90 .DNA was extracted from leukocytes in serum samples from patients and controls. The polymorphism of two regions of SERT was assessed. We gave patients drugs personally ,and recall them after a period of treatment. The date was assessed by SPSS 13.0.Result: Female gender was more prevalent among IBS patient than male(1:0.42). Besides the common lower GI symptoms there were more prevalent disorder in constitutional functions(waist pain 64.7%;poor sleep 76.5%; headache 64.7% ; loss appetite 79.4%; muscle pain 70.6%). Symptom referred to the upper GI were more prevalent in IBS-C than IBS-D, IBS-C reported higher prevalence of early fullness (p<0.05). Compared with the normal in china, IBS patient showed higher scoresreferred to the somatization (p<0.01),depression(p<0.05) and anxiety (p<0.05) in SCL-90 scores. The L/L genotype is more prevalent in cIBS patients compared with dIBS(p<0.05),whereas the L/S genotype is more common in dIBS. The symptom scores differs significantly after treatment(p<0.05),especially Tegaserod in cIBS patients.Conclusion: Besides the common lower GI symptoms there were more prevalent disorder in the upper GI and constitutional functions. Symptom referred to the upper GI were more prevalent in IBS-C than IBS-D. IBS patient is more likely to accompanied by psychiatric disorders, especially depression, anxiety and somatization. It is conceivable that the presence of the L/L genotype in IBS patients carries an increased risk of cIBS,whereas the presence of the L/S genotype carried an increased risk of in dIBS. The symptom scores differs significantly after treatment.