肠易激综合征发病机制进展

肠易激综合征(IBS)是常见的功能性胃肠病之一,在发达国家人群发病率为10％～20％.IBS的症状,如慢性腹痛、腹部不适或腹胀、腹泻或便秘由特定的外周机制引起,其中以中枢和外周疼痛过敏最为重要.尽管近年在IBS的病因和发病机制上学者们作了一系列研究,但其详细的病因和发病机制目前尚未完全明确.大量研究表明IBS可能涉及多种因素,包括内脏高敏感性、脑-肠轴功能失调、肠道动力异常、肠道细菌感染与菌群失调、遗传与免疫因素、精神心理因素等.结肠传输异常和直肠排空障碍、肠腔内刺激物或消化不良的碳水化合物、脂肪、胆汁酸过剩、肠腔内和黏膜的刺激物改变黏膜的通透性、肠道内分泌细胞的产物及对炎性反应或胆汁酸合成变化的遗传敏感性[1],引起免疫激活或炎性反应的发生.     

肠易激综合征病因与发病机制的新进展

肠易激综合征(IBS)是一种慢性功能性肠道疾病,其临床特点为慢性反复发作的腹痛、腹部不适及排便习惯改变。对患者生活质量和社会交往有明显的负面影响,并直接或间接地消耗大量公共卫生资源,成为亟待解决的公共卫生问题。近年来,人们对于IBS的病因及发病机制有了更深入的认识,新的理论观点不断涌现。作者就目前在该领域的最新进展作一综述。     

肥大细胞在肠易激综合征发病机制中的作用（综述）

目的:综述肠肥大细胞(MC)在肠易激综合征(IBS)发病机制中作用的目前认识。方法:选择涉及到MC病理生理作用的文章,重点是近年来有关肠MC在IBS发病机制中作用的文章。结果:肥大细胞在IBS的发病机制中可能发挥着一定的作用。结论:在IBS的发病机制中,肥大细胞可能是肠道、免疫和神经系统之间一种重要中间媒介。     

肠易激综合征

肠易激综合征是指因肠道功能紊乱所致的,以腹痛、腹胀、腹泻及便秘为主要表现的一组症候群。可伴有全身性神经官能症状。既往的命名比较混乱,诸如结肠过敏、结肠痉挛、结肠功能紊乱、痉挛性结肠炎、粘液性结肠炎、功能性腹泻等等。本病约占肠道门诊人数的30％。各年龄组均有发病,女性明显于男性,女:男约为7:3,40～50岁年龄组发病率最高。临床特点本病呈慢性经过,临床表现复杂。病人常感到十分痛苦,四处求医,治疗效果多不理想。根据病人的症状特     

肠易激综合征动力异常及其机制

肠易激综合征(irritablebowelsyndrome ,IBS)是一种以肠道功能异常为主要表现的功能性疾病,其功能异常的表现可有多方面,动力异常是其中的重要表现形式之一。动力异常可表现为结肠动力异常、小肠动力异常、其他消化道动力异常,甚至消化道外动力异常。IBS一般据其症状分为便秘型(IBS -C)、腹泻型(IBS -D)、交替型(IBS -A)。此外,有人根据动力异常的形式分为痉挛性结肠综合征(SCS)、功能性腹泻(FD)、腹泻为主的痉挛性结肠综合征(DPSCS)和小肠动力异常(MGD)四种[1 ] 。兹将IBS动力异常及其机制研究简单回顾如下。1　动力异常的形…     

肠易激综合征患者发病危险因素调查研究

目的：探讨影响肠易激综合征（ IBS）发病的危险因素,为早期预防和干预提供依据。方法采用病例对照的研究方法,将确诊的90例IBS患者作为病例组,同时收集非消化系统疾病患者90例作为对照组;对所有病例进行问卷调查,采用单因素和多因素分析IBS发病的危险因素。结果单因素分析结果显示,酗酒史、喜辛辣食物、喜油炸食物、喜腌制食品、胃肠道感染史、家族性腹泻史、长期服药史、长期紧张状态、失眠、疲劳程度、心情焦虑、心情抑郁、性格内向、敏感性格等因素对IBS存在相关性;多因素分析结果显示：酗酒史（OR＝3．294）、喜辛辣食物（OR＝3．927）、胃肠道感染史（OR＝4．884）、长期服药史（OR＝5．155）、长期紧张状态（OR＝2．656）、失眠（OR＝8．474）、心情焦虑（OR＝2．433）、性格内向（ OR＝1．958）。结论影响肠易激综合征发病的独立危险因素较多,应针对这些高危因素制订有效干预措施。     

17例中小学生肠易激综合征的发病原因分析

肠易激综合征（IBS）是一种常见的肠道功能性疾病，其病因和发病机理目前尚未完全清楚。病因多与精神因素、应激、遗传因素、胃肠动力学变化、肠道感染等因素有关，是一种以平滑肌功能紊乱为主要表现的疾病。我们观察了17例该症患儿，其发病原因多与精神因素有关，现报告如下：     

17例中小学生肠易激综合征的发病原因分析

<正>肠易激综合征(IBS)是一种常见的肠道功能性疾病,其病因和发病机理目前尚未完全清楚。病因多与精神因素、应激、遗传因素、胃肠动力学变化、肠道感染等因素有关,是一种以平滑肌功能紊乱为主要表现的疾病。我们观察了17例该症患儿,其发病原因多与精神因素有关,现报告如下:     

关注肠易激综合征

罗金燕 西安交通大学第二医院消化科教授、博士导师,陕西省消化内科学会副主任委员,陕西肝病学会主任委员。记者：罗教授肠易激综合征听起来好像比较陌生,您能否介绍一下什么是肠易激综合征?它是否属于常见病吗?罗教授：肠易激综合征是常见病,过去常常诊断为结肠过敏、过敏性结肠炎、痉挛结肠或胃肠神经官能症等,这些诊断较混乱。现在国内外规范化的诊断为“肠易激综合征”,简称为IBS。肠易激综合征是肠道功能紊乱为主的综合征,主要症状是与排便有关的腹痛、腹胀、排便习惯和排便性状的改变。诊断本病首先应排除肠道或全身器质性病…     

Postinfectious irritable bowel syndrome

Postinfectious irritable bowel syndrome (IBS) is a subgroup of IBS. Patients with an episode of bacterial gastroenteritis may have a 12-fold increased risk of developing IBS symptoms within the same year. The IBS can be manifested in each of its clinical types, but the diarrhea-predominant form occurs most commonly. The primary pathophysiologic factor in developing IBS after enteral infection may be defects in enteric nervous system which can produce abnormality in visceral hypersensitivity and intestinal motility. These patients also display exaggerated increases in mucosal immunocompetent T lymphocytes and an abnormally high pro- versus anti-inflammatory cytokine ratio, providing evidence to the contribution of the immune system in the development of postinfectious IBS. Via bi-directional brain-gut interactions both peripheral and central events can play a role in the development of clinical symptoms. Stress is associated with significant worsening of the complaints in IBS and may also result in a shift in the host-gut microbial relationship. IBS itself may predispose patients to acute bacterial gastroenteritis because of the altered intestinal motility. It needs further clarifying the relationship between IBS and small intestinal bacterial overgrowth syndrome. Upon the data so far the altered intestinal flora in IBS would merely reflect developments due to altered motility and not a causal relationship. The treatment of postinfectious IBS does not differ principally from that of the idiopathic IBS. Antibiotics or probiotics may lead to temporary symptomatic improvement, but, given the lack of evidence based data, they cannot be advised for routine use so far.     

Genetic background of irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional disorder which affects the 20% of the population. The exact origin is unknown. IBS is the result of interaction of genes and environmental factors. Familial aggregation and higher concordance rate of monozygotic twins compared to dizygotic twins provide evidence for the importance of genetic factors in the pathogenesis of IBS. Interest has focused on genetic variants of serotonin transporter and receptors, because of their role in gut motility, visceral sensitivity, immune processes and mood. Firm conclusions about the role of serotonin system, as well as other neuroreceptors, G-proteins, cytokine polymorphisms in the pathogenesis of IBS cannot be made.     

The pathophysiology of irritable bowel syndrome

The irritable bowel syndrome (IBS) is a frequent gastrointestinal disorder (10 -15% of the population).It is characterized by chronic abdominal pain with modification in the bowel habits. The diagnosis is based of ROME II criteria. The pathophysiology of the SII remains unknown . It result from visceral hypersensitivity with anomalies of the digestive motility. These anomalies are secondary of dysfunction of the brain - gut axis modulated by environmental and the psychosocial factors. The understanding of the pathophysiological mechanisms of the SII and in particular the function of the brain-gut axis will permit a better handling of the patients. Indeed, the present knowledge of the neurotransmitter implied in the communication between the central nervous system and the digestive tract are currently the basis of the new therapies aimed to modulate the mechanisms implicated in the causation of the several symptoms of IBS. These novel pharmacotherapy should reduce the indirect societal and costs of IBS.     

Brain-gut interaction in irritable bowel syndrome

Abdominal pain occurs commonly in irritable bowel syndrome. The mechanism of pain is likely to be either peripheral or central sensitization of gut nerves or aberrant brain processing. Functional brain techniques are now allowing the study of brain-gut interactions.     

Nutritional intakes in irritable bowel syndrome

Background: Irritable bowel syndrome (IBS) is a chronic and relapsing bowel disorder that affects 12% of the UK population. Two‐thirds of patients perceive their symptoms to be diet related (Simren, 2001) and restrict their food intake hoping to improve symptoms. This may put them at risk of low nutrient intakes. This study aimed to assess the dietary intake of IBS patients and compare nutrient intake to control subjects. Methods: Patients with IBS and controls were recruited from gastroenterology clinics from local hospitals. Controls were patients who were attending for colonoscopy surveillance for colon cancer or polyps and had a normal bowel habit with no history of IBS symptoms. Each consenting subject completed a validated food frequency questionnaire (FFQ; Bingham, 1997). Energy and nutrient intakes (excluding supplements) were calculated and comparisons were made between groups and with the UK DRVs. Data were compared between the IBS and control groups using unpaired t‐tests or Mann–Whitney U‐tests and a P < 0.05 was considered statistically significant. For nutrients with a significant difference, one‐sample t‐tests were used to determine the significance of any differences between the IBS group and DRVs. Results: Food frequency questionnaires were completed on 34 patients with IBS (35.3 ± 10.3 years; six male) and 17 controls (46.5 ± 9.8 years; 12 male). Energy and macronutrient intakes were similar between groups ( Table 1 ). Intakes of calcium and iron were significantly lower in the IBS group than in controls. Nine women had a calcium intake and nine women had an iron intake below the reference nutrient intake. Twenty‐five (74%) patients with IBS and eight (47%) controls (chi‐squared test, P = 0.1) were taking supplements compared with 35% of respondents in the 2003 National Diet & Nutrition Survey. Nine (26%) patients with IBS and six (35%) controls (chi‐squared test, P = 0.7) were taking either multivitamins or multivitamins & minerals.

Table 1. Energy and nutrient intakes of controls and IBS patients