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Síndrome del intestino irritable: una revisión clínica

William D Chey¹, Jacob Kurlander¹, Shanti Eswaran¹

¹Division of Gastroenterology, University of Michigan Health System, Ann Arbor.

|March 4, 2015

Resumen

El síndrome del intestino irritable (IBS) es una afección común diagnosticada por síntomas y excluyendo otras enfermedades. El manejo efectivo implica tratamientos personalizados y holísticos que incluyen dieta, estilo de vida y cambios de comportamiento.

Área de la Ciencia:

Gastroenterología y Gastroenterología.
Medicina interna es la medicina interna de las enfermedades.

Sus antecedentes:

El síndrome del intestino irritable (SII) afecta a una parte significativa de la población mundial, afectando la calidad de vida y la productividad laboral.
El SII es una condición compleja con diversas patologías subyacentes, no una sola entidad de enfermedad.

Objetivo del estudio:

Para sintetizar la evidencia actual sobre la epidemiología, fisiopatología y diagnóstico del SII.
Proporcionar recomendaciones de tratamiento basadas en la evidencia y prácticas para los médicos que manejan pacientes con SII.

Principales métodos:

Búsqueda exhaustiva de la literatura de Ovidio (MEDLINE) y la Base de Datos Cochrane de Revisiones Sistemáticas desde 1946 hasta diciembre de 2014.
La inclusión de 139 artículos centrados en la fisiopatología, el diagnóstico y el tratamiento del SII.

Principales resultados:

El desarrollo del SII involucra múltiples factores: microbioma intestinal, permeabilidad intestinal, función inmune, motilidad, sensación visceral, interacciones cerebro-intestino y estado psicosocial.
El diagnóstico se basa en criterios de síntomas, exclusión de banderas rojas y pruebas específicas para descartar enfermedades orgánicas.
La selección del tratamiento se guía por los síntomas predominantes (IBS-D, IBS-C, IBS-M) e incluye intervenciones dietéticas, de estilo de vida, médicas y conductuales.

Conclusiones:

Un diagnóstico preciso del SII requiere identificar los síntomas característicos y excluir otros trastornos gastrointestinales.
El manejo óptimo del paciente requiere un enfoque individualizado y holístico que incorpore diversas estrategias terapéuticas.

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