功能性胃肠病

有一些很常见的症状,如恶心、暖气、反食、反胃、吞咽受堵感、消化不良、腹胀、胸骨后不适、上腹部疼痛、烧心、早饱或便秘、腹泻、腹痛,在便后可缓解,有的同时伴有心理或精神障碍。这些症状,用常规的检查很难发现有明确的病理变化,而与胃肠运动紊乱和感觉过敏有关,被诊断为功能性胃肠病。     

闹腾的功能性胃肠病

等不及30米外的洗手间35岁的销售经理陈先生,肚子经常闹情绪：说痛就痛,想拉就拉,随时随地可能出状况。有一天晚上独自在办公室加班,急得竞连30米外的洗手间都赶不及去。     

功能性胃肠病的中医药治疗

功能性胃肠病又称胃肠道功能紊乱，是一组胃肠综合征的总称，多伴有精神因素的背景，以胃肠道运动功能紊乱为主，而经检查排除器质性病因。临床表现主要是胃肠道的有关症状，因症状特征而有不同命名。常伴有失眠、焦虑、抑郁、头昏、头痛等其他功能性症状。根据本病的发病特点，属中医学的梅核气、呕吐、泄泻、便秘等病证的范畴。现辨证施治如下：     

功能性胃肠病影像学检查技术研究与临床应用

目的:阐述胃肠功能检查标记物用于胃肠功能检查的效果、优势及临床意义.方法:30例健康人和50例便秘病人一次吞服10粒标记物后行腹部X线检查,直至标记物完全排出为止.结果:与健康人相比,便秘病人标记物在结、直肠内存留时间明显长于健康人,(P<0.01).而在胃、小肠存留的时间虽然有所延长,但差异无统计学意义,(P>0.05).结论:胃肠功能检查标记物用于胃肠功能检查图像清晰,定位准确,结果可靠,具有功能和形态兼顾,不仅能准确反映药物在消化道内运行时间,而且可以观察药物的崩解、消化过程,能为便秘分型提供准确数据.     

功能性胃肠病的临床观察

目的探究功能性肠胃病在临床中的表现;方法选取2013年1月至2014年1月在我院接受治疗的62例功能性胃肠病患者作为研究对象,对其进行有针对性的综合治疗,观察其在临床中的治疗效果:结果 62例患者中,45例(72.58%)患者的临床症状出现明显好转,15例(24.19%)患者的临床症状有好转迹象,仅有2例(3.23%)患者的症状没有变化;结论对于功能性胃肠病患者不仅要进行药物治疗,还应该结合进行心理护理,并严密观察患者的个人反应,唯有如此才能高效的完成治疗目的。     

功能性胃肠病的临床分析

目的 探究分析功能性胃肠病患者在临床上主要症状表现、相关特点以及治疗方式.方法 选自我院2010-2012年消化内科收治的功能性胃肠病患者共50例,对其进行心理、饮食习惯调节以及药物等综合性治疗,对其临床资料以回顾性的方法进行分析,归纳该疾病的临床特点.结果 有27例功能性胃肠病患者出现严重的心理障碍,占据所有患者比例的54.0％;通过对患者进行联合治疗,有34例患者出现明显好转,临床治疗总有效率为68.0％.结论 功能性胃肠病对患者的生活质量以及生命健康造成严重的威胁,在临床上表现为慢性或者反复发作性,需要心理治疗与药物治疗相结合,最大程度提高临床治疗有效率.     

解读功能性胃肠病

啥是功能性胃肠病功能性胃肠病又称胃肠神经官能症、非溃疡性消化不良（以胃部症状表现为主者）、肠易激综合征（以肠道症状表现为主者）。本病在世界各地均有发生。据文献报告,一些发达国家比发展中国家罹患率更高,如美国女性发病率高达80％,主要发生在知识妇女。     

精神心理因素在功能性胃肠病中的诊疗及护理探讨

为了确定对精神病患者进行健康教育的内容、方式和时机,探讨精神心理因素在功能性胃肠病中的诊疗及护理。笔者通过对患者心理进行分析并提出对策。根据精神病患者心理状态及不同时期,给予适时的心理护理。由于患者的性格、文化程度、家庭状况不同,心理状态及其要求也不尽相同。所治疗疾病由高至低依次为：精神分裂症、心境障碍、神经症、应激相关障碍、急性短暂性精神病等。精神心理因素在功能性胃肠病中有其自身的特点。     

功能性胃肠病诊断与治疗的临床研究

目的-探讨功能性胃肠病的诊断方法及内科常规药物治疗＋心理治疗＋抗抑郁药物联合治疗功能性胃肠病的疗效及安全性。方法：将确诊的功能性胃肠病患者206例随机分为两组各103例,对照组给予内科常规治疗,研究组给予内科常规药物治疗＋心理治疗＋抗抑郁药物联合治疗,疗程3-4周。结果：研究组总有效率为82％,对照组为62％,两组比较差异有显著性（P〈0．05）结论：内科常规药物治疗＋心理治疗＋抗抑郁药物联合治疗功能性胃肠病疗效显著,安全性好。     

什么是功能性胃肠病

您有很想吃,但吃一点就胃部饱胀的感觉吗？有经常嗳气、烧心、腹胀的感觉吗?体外出旅游便会感到腹部不适,想上厕所;遇到气候改变或受凉就会腹疼或腹泻;在考试或情绪紧张时出现排便感……如果是的话,您就有可能患有我们下面要谈到的两种综合征——功能性消化不良(FD)和肠易激综合征(IBS)。     

胃肠起搏治疗胃肠动力紊乱性疾病

胃肠动力紊乱性疾病十分常见，其发病率正呈上升趋势。目前对胃肠动力紊乱性疾病的治疗主要依赖促胃肠动力药物，但部分患不能获得满意的疗效。另外，由于药物耗资的迅猛增加及药物相互作用，既加重了患的经济负担，也引起了人们对药物不良反应及安全性的忧虑。故探索实用、经济、安全有效的新的治疗方法，有十分重要的意义。近年，采用胃肠起搏治疗胃肠动力紊乱性疾病日益受到关注。本收集近期献，结合我们自己的工作，从胃肠起搏的原理、方法、对胃肠动力的影响及在胃肠动力紊乱性疾病治疗中的应用诸方面进行综述。     

功能性胃肠障碍患者的心理和社会因素研究

目的　探讨功能性胃肠障碍 (FGD)与心理社会因素的关系。方法　应用艾森克个性问卷 [EPQ]、心理应付方式问卷[CSQ]、生活事件量表 [LES]、社会支持评定量表 [SSRS]对 5 6例FGD患者进行心理社会因素调查。并与健康人对照比较分析。结果　FGD患者具有内向、神经质个性倾向者显著高于对照组 (P <0 0 5～ 0 0 1) ;应付防御方式多采用消极应付 (P <0 0 5 ) ;就诊前 ,年内遇到的生活事件 ,特别是负性生活事件显著高于对照组 (P <0 0 5 ) ;而社会支持却明显不足 (P <0 0 5 )。结论　FGD患者具有内向、神经质个性倾向和消极应付防御等心理人格上的易感因素 ,在生活事件 ,特别是负性生活事件和社会支持不足的外界社会因素作用下 ,促发了其心理—生理应激机制 ,可能是导致FGD的重要原因     

抗抑郁药治疗功能性胃肠病的临床研究

目的探讨精神情绪因素与功能性胃肠病(FGID)的关系及抗抑郁药对其的疗效.方法对62例FGID患者进行心理卫生自评表(SCL-90)评分,其结果与我国常模标准分比较.然后按其消化道临床症状严重程度评分并随机分成二组,一组给予抗抑郁药5-羟色胺再摄取抑制剂(SSRI)帕罗西汀(赛乐特)或氟西汀(百忧解),均为20mg/d,疗程8周后再重新予SCL-90量表评分和消化道临床症状严重程度评分.另一组服用安慰剂相对照.结果 FGID患者SCL-90总分和各因子分显著高于我国常模标准分(P＜0.05～0.001),其中焦虑和抑郁因子分最高.抗抑郁药治疗后,其SCL-90总分和各因子分较前显著性下降(P＜0.05～0.001),且对改善消化道临床症状效果显著优于安慰剂组(P＜0.001).结论 FGID患者存在精神情绪障碍,其中焦虑和抑郁情绪障碍尤为突出.抗抑郁药物在改善FGID患者精神情绪障碍的同时对改善其消化道症状有确切的疗效.     

Diet and Pediatric Functional Gastrointestinal Disorders in Mediterranean Countries

Background: The increased intake of FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyol) rich foods has been suggested as a possible trigger of functional gastrointestinal disorders (FGIDs). Despite the high FODMAP content, the Mediterranean diet (MD) appears to have beneficial effects on health. Our aim was to evaluate whether the prevalence of FGIDs in different Mediterranean countries may be influenced by FODMAP consumption and adherence to the MD. Methods: A school-based, cross-sectional, multicenter study was performed in six countries in the Mediterranean area: Croatia, Greece, Israel, Italy, Macedonia, and Serbia. Subjects 4-18 years were examined in relation to their eating habits and the presence of FGIDs, using Rome IV criteria, 3-day food diaries and Mediterranean Diet Quality Index in Children and Adolescents (KIDMED) questionnaires. Results: We enrolled 1972 subjects between 4 and 9 years old (Group A), and 2450 subjects between 10 and 18 years old (Group B). The overall prevalence of FGIDs was 16% in Group A and 26% in Group B. FODMAP intake was significantly different among countries for both age groups. In both groups, no significant association was found between FGIDs and FODMAPs. Adherence to the MD in all countries was intermediate, except for Serbia, where it was low. In both groups, we found a statistically significant association between FGIDs and the KIDMED score (Group A: OR = 0.83, p < 0.001; Group B: OR = 0.93, p = 0.005). Moreover, a significant association was found between the KIDMED score and functional constipation (Group A: OR = 0.89, p = 0.008; Group B: OR = 0.93, p = 0.010) and postprandial distress syndrome (Group A: OR = 0.86, p = 0.027; Group B: OR = 0.88, p = 0.004). Conclusions: Our data suggest that the prevalence of FGIDs in the Mediterranean area is not related to FODMAP consumption, whereas adherence to the MD seems to have a protective effect.     

Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders

Gluten-free diets are increasingly chosen in the Western world, even in the absence of a diagnosis of celiac disease. Around 10% of people worldwide self-report gluten-related complaints, including intestinal and extra-intestinal symptoms. In most cases, these subjects would be labeled as patients suffering from irritable bowel syndrome (IBS) who place themselves on a gluten-free diet even in the absence of celiac disease. In some instances, patients report a clear benefit by avoiding gluten from their diet and/or symptom worsening upon gluten reintroduction. This clinical entity has been termed non-celiac gluten sensitivity (NCGS). The symptoms referred by these patients are both intestinal and extra-intestinal, suggesting that similarly to functional gastrointestinal disorders, NCGS is a disorder of gut–brain interaction. It remains unclear if gluten is the only wheat component involved in NCGS. The mechanisms underlying symptom generation in NCGS remain to be fully clarified, although in the past few years, the research has significantly moved forward with new data linking NCGS to changes in gut motility, permeability and innate immunity. The diagnosis is largely based on the self-reported reaction to gluten by the patient, as there are no available biomarkers, and confirmatory double-blind challenge protocols are unfeasible in daily clinical practice. Some studies suggest that a small proportion of patients with IBS have an intolerance to gluten. However, the benefits of gluten-free or low-gluten diets in non-celiac disease-related conditions are limited, and the long-term consequences of this practice may include nutritional and gut microbiota unbalance. Here, we summarize the role of gluten in the clinical features, pathophysiology, and management of NCGS and disorders of gut–brain interaction.     

功能性肠胃疾病患者护理方式的探讨

目的 比较传统护理方式与亲情武护理方式对功能性肠胃疾病患者康复效果的影响.方法 选择功能性肠胃疾病患者139例,随机分两组,传统护理组(68人)采取传统护理模式,亲情护理组(71人)采取亲情式护理方式.对两组病人的情绪状态、消化道症状改善情况及康复效果进行分析.结果 亲情式护理组的患者情绪状态明显优于传统护理组,且亲情式护理下的病人消化道症状的改善情况好于传统组.结论 亲情式护理方式在功能性肠胃疾病患者的治疗过程中具有明显的优势,可显著促进患者的康复.     

人性化护理对功能性消化不良患者胃肠动力及负性情绪的影响

目的探讨人性化护理对功能性消化不良（FD）患者胃肠动力及负性情绪的影响。方法选择2008年12月-2009年12月114例FD患者,随机分为两组,观察组在药物治疗的同时,采取个性化护理,对照组仅采取药物治疗,比较两组胃肠动力及负性情绪指标的变化。结果治疗后观察组胃排空率、肠排空率明显高于对照组,两组比较差异有统计学意义（P〈0.05）。观察组治疗后SAS、SDS明显低于治疗前水平（P〈0.05）,而对照组治疗前后差异无统计学意义（P〉0.05）。观察组治疗后SAS、SDS水平明显低于对照组,两组比较差异有统计学意义（P〈0.05）。结论对FD患者采用人性化护理不仅明显改善了患者的胃肠动力,并且改善了患者的心理健康,使疾病得到了良好的控制。     

Intestinal Permeability in Children with Functional Gastrointestinal Disorders: The Effects of Diet

Functional gastrointestinal disorders (FGIDs) are very common and life-impacting in children and young adults, covering 50% of pediatric gastroenterologist consultations. As it is known, FGIDs may be due to alterations in the gut–brain axis, dysbiosis and dysregulation of intestinal barrier, causing leaky gut. This may enhance increased antigen and bacterial passage through a damaged mucosa, worsening the impact of different medical conditions such as FGIDs. Little is known about the role of nutrients in modifying this “barrier disruption”. This narrative review aims to analyze the clinical evidence concerning diet and Intestinal Permeability (IP) in FGIDs in children. We searched the PubMed/Medline library for articles published between January 2000 and November 2021 including children aged 0–18 years old, using keywords related to the topic. Since diet induces changes in the intestinal barrier and microbiota, we aimed at clarifying how it is possible to modify IP in FGIDs by diet modulation, and how this can impact on gastrointestinal symptoms. We found that) is that small changes in eating habits, such as a low-FODMAP diet, an adequate intake of fiber and intestinal microbiota modulation by prebiotics and probiotics, seem to lead to big improvements in quality of life.     

Faecal Microbiota in Infants and Young Children with Functional Gastrointestinal Disorders: A Systematic Review

Functional gastrointestinal disorders (FGIDs) refer to gastrointestinal tract issues that lack clear structural or biochemical causes. Their pathophysiology is still unclear, but gut microbiota alterations are thought to play an important role. This systematic review aimed to provide a comprehensive overview of the faecal microbiota of infants and young children with FGIDs compared to healthy controls. A systematic search and screening of the literature resulted in the inclusion of thirteen full texts. Most papers reported on infantile colic, only one studied functional constipation. Despite methodological limitations, data show alterations in microbial diversity, stability, and colonisation patterns in colicky infants compared to healthy controls. Several studies (eight) reported increases in species of (pathogenic) Proteobacteria, and some studies (six) reported a decrease in (beneficial) bacteria such as Lactobacilli and Bifidobacteria. In addition, accumulation of related metabolites, as well as low-grade inflammation, might play a role in the pathophysiology of infantile colic. Infants and toddlers with functional constipation had significantly lower levels of Lactobacilli in their stools compared to controls. Microbial dysbiosis and related changes in metabolites may be inherent to FGIDs. There is a need for more standardised methods within research of faecal microbiota in FGIDs to obtain a more comprehensive picture and understanding of infant and childhood FGIDs.