Irritable bowel sydrome (IBS) is one of the most common disorders and a heterogeneous condition in view of symptoms and underlying mechanisms. Though underlying causes of pathophysiologic changes remain unclear, low grade mucosal inflammation and abnormal intestinal motility are accepted mechanisms which alter gut function and generate symptoms of IBS. First, before 1980s, abnormal colonic and rectal motor functions were regarded as the main pathophysiology of IBS, but only 25-75% of IBS patients have apparent motor abnormalities which differ from the motor functions in normal controls. So, various gastrointestinal motility tests were not indicated for the diagnosis of IBS. The high-amplitude propagating contractions of colon in IBS patients may be related to the visceral pain perception. Second, the low grade mucosal inflammation may be involved in the pathophysiology of visceral hypersensitivity. Post infectious IBS (PI-IBS) occupied 6-17% of the total IBS and some previous prospective studies reported that 7-33% of acute bacterial enteritis patients developed IBS after 6-12 months of infection. The relative risk of IBS in the gastroenteritis cohort was 11.9 and the strongest risk factor is the duration of diarrhea. After enteritis event, the increased number of immunocytes, mast cells and large amount of lymphocytes infiltration were revealed in mucosa and enteric nervous system of the gut. Beside the inflammatory cells, enterochromaffin cells, cytokines and inducible nitric oxide may be related to the pathophysiologic mechanism of PI-IBS. Lastly, the abnormalities in the gastrointestinal autonomic nervous system can induce constipation or motor disorders, but further research should elucidate it.
Gastrointestinal Motility ; Humans ; Inflammation ; Intestinal Mucosa/pathology ; Irritable Bowel Syndrome/pathology/*physiopathology ; Myoelectric Complex, Migrating

OBJECTIVETo explore the effect of Tongyouqing treating the C-IBS.

METHODAccording to rome standard II, fifty-eithy C-IBS patients were randomly divided into two groups. Control group (28 cases) were given tijiaseluo (6 mg, qd). Treatment group (30 cases) were given Tongyouqing. After treatment for 4 weeks, observing and comparing the two groups IBS symptom between treatment before and later (Bristol score, abdominal distention, abdominal angina, constipation, partial defecation, belch, mind). To understand the condition of the colonic dynamic by colonic transit trial. Comparing the effective rate of the two group and the proportion of patients still choosing the medicine which they were given.

RESULTThe symptom score of the two groups patients, there were signifi-cant differences between the two groups before treatment and after treatment (P <0.05). After treatment, treatment group is prefer to control group in the improvement of the colonic dynamic (P <0.05). The effective rate and the proportion of patients still choosing the medicine which they were given of treatment group is also more higher than control group.

CONCLUSIONTongyouqing can relieve the gastrointestinal symptom, improve the fecal character, lessen abdominal distention and abdominal angina, increase the defecating times, improve the colonic dynamic, improve the mind state quilkly and manifestly. Tongyouqing is an effective method to treat C-IBS. It deserves clinical spreading, its mechnism needs further study.

Adolescent ; Adult ; Aged ; Colon ; drug effects ; pathology ; physiopathology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Irritable Bowel Syndrome ; drug therapy ; pathology ; physiopathology ; Male ; Middle Aged ; Phytotherapy