腸躁症的防治
楊惟婷整理
腸躁症是最常見的腸胃症狀之一，但也是最常被誤解的疾病之一。
據統計，歐美國家因為腸躁症不舒服請假的天數，多到跟感冒一樣。
大部分人會以為「腸躁症」就是「腸子」的問題，甚至會因為擔心肚子長瘤，到醫院做了許多沒必要的檢查，浪費時間，結果症狀也沒改善。
其實，腸躁症是個複雜、但不會要人命的症候群，很難「藥到病除」，需要長期調養。以下整理一些腸躁症的防治方法：
一、腸躁症的特色
腸躁症的特色如下﹕
- 工業國家成年人隨時有20%會受腸躁症所苦
- 到腸胃科看診的腸躁病人，有15%有憂鬱症狀、甚至自殺意念
- 憂鬱常惡化便秘，焦慮會加快腹瀉
- 腸躁症體質的人，日常生活的壓力就有可能誘發腸躁症
- 腸躁症常因為半年前頻繁的壓力事件而爆發
- 男女性罹患腸躁症的機率均等，但女性看診次數比男性多一倍
- 腸躁症病人有50%在35歲之前發病，90%在50歲前發病
- 40%的腸躁症病人會因此減少社交活動
- 在嚴重的腸胃炎之後一段時間，病人出現腸躁症的機率會增加，這是因為腸胃炎讓病人腸道神經系統功能變差了。不過這類的腸躁症「預後」最好，能夠完全治癒的比率最高。
腸躁症常見附屬症狀﹕
- 腹部腫脹與腸子脹氣
- 不規則、可能每天都不一樣的腸子蠕動
- 消化不良
- 頭痛、背痛、肌肉痛、疲倦、頻尿
- 女性常見性交後疼痛
二、「神經失調」是腸躁症重要原因之一
人的腸道肌肉夾層裡的感覺受器對食物通過膨脹、與腸道肌肉攣縮的感覺往往是很靈敏。尤其腸躁症的人，對這些正常的感覺更是過度敏感，會引發疼痛、脹氣的感覺。而這過度敏感往往是因為神經失調。
腸躁症跟三個神經系統有關：交感神經、副交感神經或腸道神經系統的失衡，造成排便習慣改便，或對腸道脹氣、膨脹的感覺異常敏感。
三、每個人的腸躁症狀都不太一樣
腸躁症的英文是irritable bowel syndrome，syndrome就是「症候群」，意思是許多常見症狀的組合，但沒有確定的病因、以及確定診斷的病名。腸躁症無法以任何醫學檢查來確認，醫師只能從病人描述的症狀來判斷。
原本腸躁症有一套很複雜的診斷準則，但後來臨床醫師的標準越來越寬鬆，因為每個人的表現症狀都不太一樣，但從結果來看都是腸躁症。現在只要有「慢性、反覆的腹痛與不適，加上排便習慣改變」，然後又找不到其他腸道器官的損傷，臨床上就會當做是「腸躁症」。
四、腸躁症可能會長期存在
腸躁症通常跟個人體質與長期壓力有關，一旦出現腸躁症，這些症狀可能會長期出現，就算用藥物硬壓症狀，也可能會從另一個地方跑出來。病人應學習改善體質、減輕症狀的方法，但也得習慣跟腸躁症和平相處。想辦法讓症狀緩和下來、學習漸漸別太在意症狀，腸躁症的負面影響就會越來越小。
五、不用過度擔心腸躁症
腸躁症的症狀不會劇烈起伏，有腸躁症的人，平均壽命也不會縮短。
亦即腸躁症不會自己突然惡化成嚴重的癌症或腫瘤，變成致命疾病或重大傷害的機率也幾乎等於零。
治療腸躁症很重要的是：不要只是聽症狀然後直接給藥。跟病人解釋腸躁症的原理，讓病人了解腸躁症會長期存在，但不會有重大併發症，平常心面對，反而對病情會有幫助。
六、腸躁症跟壓力沒有絕對關係
雖然腸躁症跟神經失調高度相關，但最原始的病因可能是「體質」，不一定跟什麼很大的「壓力」有關。
不過，腸躁症不舒服起來，可是會增加焦慮、煩躁、失眠的症狀，甚至讓一些病人不敢出門、導致心情變差，所以反過來說，腸躁症本身就是一個「壓力」。
統計上，一些社會壓力如失業、親人過世、夫妻爭吵、財務困難、人際障礙，還是有可能誘發腸躁症變嚴重。
七、腸躁症沒有特效藥
有時，腸躁症病人可以藉由消脹氣、止痛、止瀉或軟便的藥物做「症狀治療」，但由於腸躁的主因是「神經失調」、不同人症狀的個別差異很大，所以目前並沒有腸躁症的特效藥，藥物治療的成效往往有限。病人常需要嘗試各種不同的藥物與非藥物的治療方式，或尋求不同醫師的協助。
但有研究指出，可多選擇高營養密度的蔬果，其中含有豐富膳食纖維的奇異果，更能有效幫助改善便秘型腸躁症狀。
奇異果內含的寡醣、膳食纖維以及特有的奇異酵素，這些都有助於減緩便秘，寡醣為一種「益生質」，有利於腸胃中好菌生長及促進蠕動，而膳食纖維具有高度保水性，能軟化糞便，幫助排便。另外，奇異果所含的奇異酵素（Actinidin）能促進蛋白質分解，幫助胃部排空，並加速消化道蠕動，刺激大腸黏膜，增加排便，
避免壞菌生長，減輕腸胃道的負擔。
除了奇異果外，鳳梨、木瓜、無花果都含有酵素，建議有便秘困擾的民眾都可以多多食用。
八、改善神經失調，可望減輕腸躁症狀
腸躁症主要來自腸道神經系統的過度敏感，而自律神經系統（交感與副交感）又會影響腸道神經系統。所以，只要是可以改善自律神經失調的藥物，或有氧運動、瑜伽、腹式呼吸、氣功、靜坐、催眠等，都有可能改善腸躁症狀。充足的睡眠也很重要。
九、腸躁症的飲食禁忌
腸躁症病人可能會對某些食物「過敏」，激起強烈胃腸不適，這有時必須靠病人自己察覺。大體來說，高含量的油脂、咖啡因、高纖維的食品，較容易惡化腸躁症。
傳統觀念認為，腸胃不好就是要吃稀飯、牛奶、地瓜、豆漿等對腸胃好的食物，減少消化負擔，但這種想法在醫生眼裡根本適得其反，更容易脹氣拉肚子！
胃腸肝膽科醫師張振榕表示，大腸激躁症患者最需注意的是避免脹氣，地瓜、豆漿、大蒜、洋蔥等高產氣食物，絕對不行吃。
十、精神科醫師的畫龍點睛
改善腸道神經失調的藥物，就是精神科醫師最擅長、最常開的藥物。而腸躁症拖久後，容易併發失眠、焦慮症狀，這也可以讓精神科醫師一併處理。花時間為病人解釋腸躁症，讓病人不會因為腸躁症過度擔憂、慮病，這是精神科醫師的專長。
其實不只腸躁症，像胃食道逆流、胃潰瘍等容易受壓力影響的腸胃疾病，同時看精神科往往會好更快。
如果腸躁症已經影響到生活品質，除了看胃腸科外，請記得也要到家裡附近的精神科診所聽聽醫師的建議。
本文主要資料來源：Understanding Irritable Bowel Syndrome。
作者：Dr Kieran J. Moriaty
留言列表（37条）
I found new insight from this.
I used to be able to find good advice from your articles.
There is certainly a great deal to find out about this subject. I love all the points you’ve made.
Right here is the perfect web site for anyone who really wants to find out about this topic. You understand a whole lot its almost tough to argue with you (not that I actually will need to…HaHa). You definitely put a fresh spin on a topic which has been discussed for years. Wonderful stuff, just excellent.
Hello! I simply want to offer you a huge thumbs up for the excellent info you’ve got here on this post. I’ll be coming back to your website for more soon.
Hacklink satın almak, web sitenizin görünürlüğünü artırmak ve arama motoru sıralamalarını yükseltmek için etkili bir stratejidir.
That is really interesting, You are an excessively skilled blogger. I have joined your rss feed and look forward to searching for extra of your fantastic post. Additionally, I have shared your web site in my social networks!
I’m not sure why but this blog is loading extremely slow for me. Is anyone else having this problem or is it a problem on my end? I’ll check back later on and see if the problem still exists.
Very good information. Lucky me I ran across your website by accident (stumbleupon). I’ve book-marked it for later!
Good info. Lucky me I discovered your blog by chance (stumbleupon). I’ve saved it for later.
A person essentially help to make seriously articles I would state. This is the first time I frequented your website page and thus far? I amazed with the research you made to make this particular publish incredible. Wonderful job!
You need to be a part of a contest for one of the finest websites on the web. I’m going to recommend this website!
Couldn’t agree more
Can’t wait to read more from you
Good day! Do you know if they make any plugins to assist with SEO? I’m trying to get my blog to rank for some targeted keywords but I’m not seeing very good gains. If you know of any please share. Cheers!
Great ? I should definitely pronounce, impressed with your website. I had no trouble navigating through all tabs as well as related info ended up being truly easy to do to access. I recently found what I hoped for before you know it at all. Reasonably unusual. Is likely to appreciate it for those who add forums or something, site theme . a tones way for your client to communicate. Excellent task..
Great post! We are linking to this great content on our site. Keep up the great writing.
You have made some decent points there. I checked on the net for additional information about the issue and found most people will go along with your views on this web site.
Good day! I could have sworn I’ve been to this website before but after browsing through many of the posts I realized it’s new to me. Anyways, I’m certainly pleased I discovered it and I’ll be bookmarking it and checking back frequently!
I have to thank you for the efforts you have put in penning this blog. I am hoping to view the same high-grade content from you in the future as well. In truth, your creative writing abilities has motivated me to get my own, personal site now 😉
I must thank you for the efforts you’ve put in writing this site. I’m hoping to view the same high-grade blog posts from you later on as well. In fact, your creative writing abilities has encouraged me to get my own, personal site now 😉
I blog quite often and I seriously thank you for your content. The article has truly peaked my interest. I’m going to take a note of your website and keep checking for new information about once a week. I opted in for your Feed as well.
Have you ever thought about including a little bit more than just your articles? I mean, what you say is important and everything. But just imagine if you added some great graphics or videos to give your posts more, “pop”! Your content is excellent but with images and videos, this site could definitely be one of the greatest in its niche. Amazing blog!
home furnitures that uses hardwoord is a great option because hardwoods last longer*
I don?t even understand how I ended up right here, but I believed this publish used to be great. I don’t recognize who you are however certainly you’re going to a well-known blogger in case you are not already 😉 Cheers!
Generally I do not read post on blogs, but I would like to say that this write-up very forced me to try and do so! Your writing style has been amazed me. Thanks, quite nice post.
Scam
Pretty! This has been an incredibly wonderful article. Thanks for supplying this info.
News on why News became valuable to most of people.
A motivating discussion is worth comment. I do think that you ought to publish more on this subject, it may not be a taboo matter but typically people do not discuss such issues. To the next! All the best.
Aw, this was a really nice post. Finding the time and actual effort to produce a very good article… but what can I say… I procrastinate a lot and never seem to get anything done.
There is certainly a lot to know about this topic. I really like all the points you’ve made.
My brother recommended I would possibly like this web site. He was once totally right. This submit truly made my day. You cann’t consider just how a lot time I had spent for this information! Thank you!
bookmarked!!, I really like your site.
This is a topic that is near to my heart… Best wishes! Where can I find the contact details for questions?
Hi, I do think this is an excellent web site. I stumbledupon it 😉 I will return once again since i have bookmarked it. Money and freedom is the best way to change, may you be rich and continue to help others.
An impressive share! I’ve just forwarded this onto a friend who was doing a little homework on this. And he in fact ordered me dinner simply because I found it for him… lol. So allow me to reword this…. Thanks for the meal!! But yeah, thanks for spending time to discuss this topic here on your web site.