刺激性肠综合征:临床综述
William D Chey1, Jacob Kurlander1, Shanti Eswaran1
1Division of Gastroenterology, University of Michigan Health System, Ann Arbor.
JAMA
|March 4, 2015
概括
刺激性肠综合征 (IBS) 是一种常见的疾病,通过症状诊断并排除其他疾病. 有效的管理涉及个性化,整体的治疗,包括饮食,生活方式和行为改变.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 刺激性肠综合征 (IBS) 影响全球人口的很大一部分,影响生活质量和工作生产力.
- IBS是一种复杂的疾病,具有多种不同的潜在病理,而不是单一的疾病实体.
研究的目的:
- 综合目前关于IBS流行病学,病理生理学和诊断的证据.
- 为管理IBS患者的临床医生提供基于证据的实际治疗建议.
主要方法:
- 从1946年到2014年12月,对奥维德 (MEDLINE) 和科克伦系统评价数据库进行了全面的文献搜索.
- 包括139篇专注于IBS病理生理学,诊断和治疗的文章.
主要成果:
- IBS的发展涉及多个因素:肠道微生物群,肠道透性,免疫功能,运动性,内脏感觉,脑肠相互作用和心理社会地位.
- 诊断依赖于症状标准,排除红旗,以及专门的测试来排除有机疾病.
- 治疗选择以主要症状 (IBS-D,IBS-C,IBS-M) 为指导,包括饮食,生活方式,医疗和行为干预措施.
结论:
- 准确的IBS诊断需要识别特征性症状,并排除其他胃肠道疾病.
- 最佳的患者管理需要个性化,整体的方法,包括各种治疗策略.
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