• Confocal microscopy
• Cornea
• Dry eye
• In vivo confocal microscopy

AIM: To investigate the prevalence of and risk factors for irritable bowel syndrome (IBS) among young adults below the age of 35 in Nanning, Guangxi, to provide a reference for the prevention and control of this disease.

METHODS: A total of 1214 subjects below the age of 35 from five urban areas of Nanning were interviewed face-to-face by using a questionnaire survey designed according to Roman Ⅲ Diagnosis Standard and relevant epidemiological factors, in order to investigate the prevalence of and risk factors for IBS among young adults in Nanning.

RESULTS: A total of 63 cases of IBS were detected in the survey. The prevalence of IBS among young adults below the age of 35 was 5.19%. The prevalence of IBS was significantly different in different urban areas and occupations, and was significantly higher in students than in on-the-job personnel (P < 0.05). Univariate analysis showed that eating cold food, spicy food, fruits, dairy products and other factors such as catching a cold, fatigue, poor mood, and spirit boost in the respondents were significantly associated with IBS (P < 0.05). Multivariate logistic regression analysis showed that cold food and fruits were independent risk factors for IBS among young adults in Nanning, with the odds ratio (OR) values of 2.255 and 2.076, respectively (P < 0.05).

CONCLUSION: The prevalence of IBS among young adults below the age of 35 years in Nanning is 5.19%. Cold food and fruits are independent factors for this disease.

• Irritable bowel syndrome
• Rome III criteria
• Epidemiology
• Risk factors

Irritable bowel syndrome (IBS) is a common condition characterized by abdominal pain or discomfort, bloating, and altered stool form and passage. Small intestinal bacterial overgrowth (SIBO) is a condition in which there is overgrowth of bacteria in small bowel in excess of 10⁵ colony forming units per milliliter on culture of the upper gut aspirate. Frequency of SIBO varied from 4%-78% among patients with IBS and from 1%-40% among controls. Higher frequency in some studies might be due to fallacious criteria [post-lactulose breath-hydrogen rise 20 PPM above basal within 90 min (early-peak)]. Glucose hydrogen breath test (GHBT) has a low sensitivity to diagnose SIBO. Hence, studies based on GHBT might have under-estimated frequency of SIBO. Therefore, it is important to analyze these studies carefully to evaluate whether the reported association between IBS and SIBO is over or under-projected. This review evaluates studies on association between SIBO and IBS, discordance between different studies, their strength and weakness including methodological issues and evidence on therapeutic manipulation of gut flora on symptoms of IBS.

• Glucose hydrogen breath test
• Lactulose hydrogen breath test
• Functional bowel disease
• Dysbiosis
• Gut flora

• Animals
• Anti-Bacterial Agents/therapeutic use
• Bacteria/growth & development
• Bacteria/metabolism
• Breath Tests
• Fermentation
• Host-Parasite Interactions
• Humans
• Intestine, Small/metabolism
• Intestine, Small/microbiology
• Irritable Bowel Syndrome/diagnosis
• Irritable Bowel Syndrome/metabolism
• Irritable Bowel Syndrome/microbiology
• Irritable Bowel Syndrome/therapy
• Phenotype
• Predictive Value of Tests
• Probiotics/therapeutic use
• Risk Factors
• Treatment Outcome

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders, characterized by abdominal pain, bloating, and changes in bowel habits. These symptoms cannot be explained by structural abnormalities and there is no specific laboratory test or biomarker for IBS. Therefore, IBS is classified as a functional disorder with diagnosis dependent on the history taking about manifested symptoms and careful physical examination. Although a great deal of research has been carried out in this area, the pathophysiology of IBS is complex and not completely understood. Multiple factors are thought to contribute to the symptoms in IBS patients; altered gastrointestinal motility, visceral hypersensitivity, and the brain-gut interaction are important classical concepts in IBS pathophysiology. New areas of research in this arena include inflammation, postinfectious low-grade inflammation, genetic and immunologic factors, an altered microbiota, dietary factors, and enteroendocrine cells. These emerging studies have not shown consistent results, provoking controversy in the IBS field. However, certain lines of evidence suggest that these mechanisms are important at least a subset of IBS patients, confirming that IBS symptoms cannot be explained by a single etiological mechanism. Therefore, it is important to keep in mind that IBS requires a more holistic approach to determining effective treatment and understanding the underlying mechanisms.

• Pathophysiology
• Irritable bowel syndrome
• Inflammation
• Immunologic
• Genetics
• Microbiota
• Diet
• Enteroendocrine cell

• Animals
• Diet/adverse effects
• Enteroendocrine Cells/metabolism
• Genetic Predisposition to Disease
• Humans
• Inflammation Mediators/metabolism
• Intestinal Mucosa/metabolism
• Intestines/immunology
• Intestines/innervation
• Intestines/microbiology
• Intestines/physiopathology
• Irritable Bowel Syndrome/genetics
• Irritable Bowel Syndrome/immunology
• Irritable Bowel Syndrome/metabolism
• Irritable Bowel Syndrome/microbiology
• Irritable Bowel Syndrome/physiopathology
• Phenotype
• Prognosis
• Risk Factors
• Signal Transduction

Irritable bowel syndrome (IBS) is common in the society. Among the putative pathogeneses, gut dysmotility results in pain and disturbed defecation. The latter is probably caused by the effect of abnormal gut water secretion. The interaction between abnormal gas accumulation, abdominal pain and bloating remains controversial. Visceral hypersensitivity and its modification along with the central transmission are the characteristics of IBS patients. The identification of biologic markers based on genetic polymorphisms is undetermined. Imbalanced gut microbiota may alter epithelial permeability to activate nociceptive sensory pathways which in turn lead to IBS. Certain food constituents may exacerbate bowel symptoms. The impact of adult and childhood abuses on IBS is underestimated. Using the concept of biopsychosocial dysfunction can integrate multidimensional pathogeneses. Antispasmodics plus stool consistency modifiers to treat the major symptoms and defecation are the first-line drug treatment. New drugs targeting receptors governing bowel motility, sensation and secretion can be considered, but clinicians must be aware of their potential serious side effects. Psychiatric drugs and modalities may be the final options for treating intractable subjects. Probiotics of multi-species preparations are safe and worth to be considered for the treatment. Antibiotics are promising but their long-term safety and effectiveness are unknown. Diet therapy including exclusion of certain food constituents is an economic measure. Using relatively safe complementary and alternative medicines (CAMs) may be optional to those patients who failed classical treatment. In conclusion, IBS is a heterogeneous disorder with multidimensional pathogeneses. Personalized medicines with multidisciplinary approaches using different classes of drugs, psychiatric measures, probiotics and antibiotics, dietary therapy, and finally CAMs, can be considered.

• Antispasmodics
• Biopsychosocial dysfunction
• Comorbidity
• Genetics
• Irritable bowel syndrome
• Microbiota
• Probiotics
• Visceral hyperalgesia

• Animals
• Anti-Bacterial Agents/therapeutic use
• Combined Modality Therapy
• Complementary Therapies
• Diet/adverse effects
• Gastrointestinal Agents/therapeutic use
• Genetic Predisposition to Disease
• Humans
• Intestines/drug effects
• Intestines/innervation
• Intestines/microbiology
• Intestines/physiopathology
• Irritable Bowel Syndrome/diagnosis
• Irritable Bowel Syndrome/etiology
• Irritable Bowel Syndrome/genetics
• Irritable Bowel Syndrome/physiopathology
• Irritable Bowel Syndrome/psychology
• Irritable Bowel Syndrome/therapy
• Probiotics/therapeutic use
• Psychotherapy
• Risk Factors
• Risk Reduction Behavior
• Treatment Outcome