Abstract
lrritable bowel syndrome (IBS) and non-ulcer dyspepsia (NUD) are considered to be typical stressinduced diseases of the digestive system. These two diseases are considered to be caused by dysfunctions in the digestive system. We experienced a case in which the IBS seemed to change over time to NUD during the patient's long clinical course. We herein report the clinical course of the changes in the motility function of the gallbladder for this patient. The patient was a 21-year-old female. Three years ago she first complained of severe constipation and lower abdominal pain. She was admitted to our hospital with a diagnosis of IBS, and her gallbladder dilated after caerulein injection paradoxically. Because her symptoms improved after psychosomatic therapy, she was eventually discharged. The stress-induced by job-hunting caused her to develop strong upper abdominal pain. She was later diagnosed as having NUD and thus was hospitalized for the second time. Her gallbladder contracted after caerulein injection weakly but definitely, which differs apparently from the response observed during the initial admission. During the clinical course her symptoms also change along with the gallbladder motility. According to these findings, it is presumed that a generalized abnormality of the smooth muscle of the digestive tract is basically exsisted in both IBS and NUD, which can possibly cause overlapping or syndrome shift to each other.
