Takano Hospital is a coloproctological surgical center in Kumamoto, Japan. The department of psychosomatic medicine was started in April 1986 to approach to psychosomatic problems in the field. Psychosomatic aspects of adolescents with irritable bowel syndrome were studied in twenty-two patients aged 13-19 yrs, who visited the department of psychosomatic medicine during a two year period of April, 1986-March, 1988. During the same period, the numbers of the whole patients who visited our department were 167. The results are summarized as follows : 1) Twenty-two adolescent patients, 3 males and 19 females with irritable bowel syndrome took up 77.3% of the whole adolescent patients in the department of psychosomatic medicine. 2) In the clinical patterns of adolescent patients with irritable bowel syndrome the "gas" pattern was dominant (59.1%). Patients with the gas pattern have mainly severe symptoms of flatus, fullness, rumbling sound and abdominal pain as well as bowel dysfunction, diarrhea and constipation. A decline in the incidence of the gas pattern of irritable bowel syndrome was evident for other generations as there were none in childhood, 15.0% in 20-39yrs, 11.1% in 40-59yrs, 33.3% in 60yrs-. 3) School-maladjustment (53.8%) and anthropophobia (53.8%) were found in the adolescent patients with the gas pattern. The results indicate the presence of an adolescent crisis caused by gas symptoms. 4) Gas symptoms in irritable bowel syndrome could easily be distinguished from a phobia associated with self-odor by the absence of paranoid conditions. 5) It is concluded that the irritable bowel syndrome in adolescence is mainly characterized by "gas". We need a new recognition of gas in the irritable bowel syndrome in adolescence.
