機能的胃腸疾患:理解と管理における進歩
Christopher J Black1, Douglas A Drossman2, Nicholas J Talley3
1Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
Lancet (London, England)
|October 13, 2020
まとめ
機能的胃腸障害や 腸と脳の相互作用の障害は 多くの人に影響し 複雑な原因があります 早期診断と治療は 患者の福祉と医療負担の軽減に不可欠です
科学分野:
- 胃腸学と腸脳軸の研究
背景:
- 機能性胃腸疾患 (FGID) は一般的であり,人口の最大40%に影響を与え,しばしば慢性的な症状を伴う.
- これらの状態は 今では腸と脳の相互作用の障害と呼ばれていますが 明確な有機的な説明がなく 複雑な病理生理学を含んでいます
- 肝心な要因は腸-脳軸の調節不良,微生物の不均衡,免疫の変化,内臓過敏性,運動能力の変化などです.
研究 の 目的:
- 機能的胃腸疾患の流行と影響を強調する
- 病理生理学の複雑さと 早期診断と治療の重要性を強調します
- 現在の診断と治療の原則と将来のパーソナライズされたアプローチについて議論する.
主な方法:
- 診断は,限られた調査の賢明な使用で,症状に基づく基準に基づいています.
- 治療の原則は生体心理的モデルで 身体的および心理的な症状に対応しています
- FGIDにおける腸-脳軸,微生物不活性化,免疫機能に関する研究が行われています.
主要な成果:
- FGIDは,繰り返し診察や介入を行うことで,生活の質,労働能力,医療システムに大きな影響を及ぼします.
- 心理的な併発症は頻繁に見られるが,症状の発症との関係は不明である.
- 現在の管理は症状制御と生体心理学的アプローチに焦点を当てています.
結論:
- 腸-脳相互作用の障害の効果的な特定と管理は,その社会的および経済的負担のために極めて重要です.
- 将来の治療は,個々の病理生理学と心理学的プロファイルに基づいてパーソナライズすることを目指します.
- 慢性疾患の管理には 医師のコミュニケーションと 患者の教育が不可欠です
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