刺激性腸症候群:臨床レビュー
William D Chey1, Jacob Kurlander1, Shanti Eswaran1
1Division of Gastroenterology, University of Michigan Health System, Ann Arbor.
JAMA
|March 4, 2015
まとめ
刺激性腸症候群 (IBS) は,症状によって診断され,他の疾患を除外される一般的な状態です. 効果的な管理には,食事,ライフスタイル,行動の変化を含む,個別化された,総合的な治療が必要です.
科学分野:
- 胃腸内科 胃腸内科
- 内科内科は,内科の内科である.
背景:
- 刺激性腸症候群 (IBS) は,世界人口のかなりの部分に影響を与え,生活の質と仕事の生産性に影響を与えます.
- IBSは,単一の疾患ではなく,さまざまな基礎疾患を持つ複雑な状態です.
研究 の 目的:
- IBSの流行病学,病理生理学,診断に関する現在の証拠を統合する.
- IBS患者の管理を担当する臨床医に,根拠に基づいた,実践的な治療勧告を提供するためです.
主な方法:
- 1946年から2014年12月までのオヴィッド (MEDLINE) とコクランの体系的なレビューのデータベースに関する包括的な文献検索.
- IBSの病理生理学,診断,治療に焦点を当てた139件の記事を掲載しました.
主要な成果:
- IBSの発症には,腸内微生物群,腸の透過性,免疫機能,運動性,内臓感覚,脳と腸の相互作用,および心理的社会的な状態など,複数の要因が関係しています.
- 診断は,症状の基準,赤旗の排除,および有機疾患を排除するための特定の検査に基づいています.
- 治療の選択は,主たる症状 (IBS-D,IBS-C,IBS-M) に基づいて行われ,食事,ライフスタイル,医療,行動に関する介入が含まれます.
結論:
- IBSの正確な診断には,特徴的な症状を特定し,他の胃腸疾患を除外する必要があります.
- 最適な患者管理には,多様な治療戦略を組み込む個別化された,総合的なアプローチが必要です.
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