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簡介

腸易激綜合症

腸易激綜合症(Irritable Bowel Syndrome) 可分為便秘型、反覆腹瀉型及便秘腹瀉兩者混合型1
腸易激綜合症屬於功能性異常的腸胃疾病1。常見症狀為腸道蠕動異常及肚子絞痛1
而便秘型的患者會有反覆便秘,排便不順等情況。究竟,腸易激綜合症在香港有多普遍?

腸易激綜合症普遍嗎?

在香港,大約有372,600人患有腸易激綜合症2,其中便秘型的患者佔百分之二十2

那什麼是便秘型腸易激綜合症呢?

便秘型腸易激綜合症的特徵包括跟便秘相關的腹痛3、症狀長期持續3及反覆發作3
患者超過25%的時間排出乾硬或塊狀大便,同時少於25%的時間排出稀爛或水狀大便3

疾病資訊

便秘型腸閉激綜合症患者在腸道蠕動的日子排出的大便,有25% 是屬於布斯里托大便形態分類法( Bristor Stool Form Scale) 的第一型及第二型4

神經過敏:腸道的神經過於敏感,令患者比常人承受更強烈的腹痛及不適。

水份吸收:大腸可能吸收過多水份,或腸道肌肉蠕動太慢,導致糞便乾硬。

大腸與腸道的聯繫:或許因大腦與腸道之間的聯繫問題,導致腹痛、不適及腸道蠕動狀況改變。

日常生活煩惱

便秘型腸閉激綜合症患者除要承受腹痛不適,還會因排便問題造成極大困擾,影響生活、工作、甚至不敢外出旅遊,因為相信旅遊會令情況惡化6 。由於無法順利排便而長時間待在洗手間,也影響了社交生活及與家人關係6 。 長期便秘可引致痔瘡7 並令生活質素下降,產生焦慮及情緒問題7 。 此外,部分日常食品可誘發或加重便秘型腸閉激綜合症,患者在飲食方面也諸多限制,有時會因擔心吃錯東西導致病情況惡化,精神變得緊張,増加生活壓力。

診斷及自我檢查

如何確診腸閉激綜合症?

診斷腸易激綜合症標準是在過往三個月,每星期至少有一日感到腹痛及反覆出現多於兩個以下症狀9 :

IBS-C還是CIC?

假若你發現便秘並非偶爾情況,可能是患上便秘型腸易激綜合症(IBS-C) 或慢性先天便秘(CIC)。

:

當你前住求診時,醫生一般會向你查問以下資料11, 以作進一步診斷 :

-         徵狀:便秘的頻密程度及有否腹痛 ?

-         你曾嘗試過什麼解 決 方法 ?

-         生活方式有變化嗎 ? 有運動嗎?最近是否轉了新的飲食餐單

-         你的徵狀如何影響你的日常生活 ?

治療方案

療法可分為非藥物及藥物治療:

疾病小貼士

參考:
  1. Halland M, Saito YA. Irritable bowel syndrome: new and emerging treatments. BMMJ: British Medical Journal 2015;350.
  2. Lee S, Wu J, Ma YL, Tsang A, Guo WJ, Sung J. Irritable bowel syndrome is strongly associated with generalized anxiet disorde : a community study. Alimentary Pharmacology & Therapeutics 2009;30:643-51
  3. Linzess. Is it IBS-C? What is IBS-C? Available at : https://www.linzess.com/ibsc-and-cic-information/ ibsc-symptoms Accessed on 4 Dec 2017.
  4. Lacy BE, Mearin F, Chang L, et al. Bowel Disorders. Gastroenterology 2016 May 1;150(6);1393-1407e5. Available from, DOI:10.1053/j.gastro.2016.02.031.
  5. Linzess. Is it IBS-C? What causes IBS-C? Available at : https://www.linzess.com/ibsc-and-cic-information/ ibsc-symptoms Accessed on 4 Dec 2017.
  6. Linzess. Patient Stories. Elaine's Story — Experience with IBS-C. Available at https://www.linzess.com/steps-toward-relief/patient-stories Accessed on 4 Dec 2017.
  7. Mayo Clinic. Irritable bowel syndrome, Complications. Availble at https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016 Accessed on 4 Dec 2017.
  8. WebMC. IBS Triggers and How to Avoid Them. Diet Triggers for IBS Constipation. Available at: https://www.webmd.com/ibs/ibs-triggers-prevention-strategies#1 Accessed on 4 Dec 2017.
  9. Linzess. Finding relief may seem like a lot of trial and error. Steps Toward Relief guide. Availble at: https://www.linzess.com/steps-toward-relief/ibsc-and-cic-next-steps Accessed on 4 Dec 2017.
  10. Linzess. How are your symptoms affecting you? Availablbe at https://www.linzess.com/steps-towad-relief/talk-with-your-doctor Accessed on 4 Dec 2017.
  11. Kwan AC, Hu WH, Chan YK, Yeung YW, Lai TS, Yuen H. Prevalence of irritable bowel syndrome in Hong Kong. Journal of gastroenterology and hepatology 2002; 17:1180-6.
  12. Park JM, Choi MG, Kim YS, et al. Quality of life of patients with irritable bowel syndrome in Korea. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation 200; 18: 435-16.
  13. Harvey RD, Mauad EC, Brown AM. Prognosis in irritable bowel syndrome: A 5-year prospective study. The Lancet 1987; 329:963-5.
  14. Medscape. Irritable Bowel Syndrome. Management. Available att: https://emedicine.medscape.com/article/180389-overview Accessed on 5 Dec 2017.
  15. Linzess. Tips to help manage your symptoms. IBS-C Tips. Available at: https://www.linzess.com/ibsc-and-cic-information/healthy-habits Accessed on 5 Dec 2017.

HK-1394 7/12/2017