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排泄障碍和排泄综合征:文学综述
Akinari Sawada1, Yasuhiro Fujiwara1
1Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Digestion
|October 16, 2023
概括
吐障碍和反综合征是常见的肠脑相互作用障碍. 识别这些行为状况,如过度胃上 (SGB) 和反综合征 (RS),是正确诊断和心理治疗的关键.
科学领域:
- 胃肠病学 胃肠病学
- 肠-大脑相互作用障碍 肠-大脑相互作用障碍
- 功能性胃肠道疾病 功能性胃肠道疾病
背景情况:
- 吐障碍和反综合征 (RS) 根据罗马IV标准被归类为肠-大脑相互作用障碍 (DGBIs).
- 排泄障碍包括过度的胃排泄 (GB) 和胃上排泄 (SGB).
- 过度的GB是生理性的,而过度的SGB和RS被认为是行为障碍.
研究的目的:
- 突出吐障碍和RS的患病率和诊断挑战.
- 强调区分这些行为障碍与PPI耐火性GERD等疾病的重要性.
- 概述过度SGB和RS的适当诊断和治疗策略.
主要方法:
- 一项大型互联网调查确定了吐障碍 (1%) 和RS (2.8%) 的患病率.
- 临床评估涉及到细致的病史.
- 客观诊断可以通过高分辨率阻抗计和/或24小时阻抗-pH监测来实现.
主要成果:
- 过度的SGB和RS不是罕见的情况.
- 这些行为障碍在患有反流症状的患者中经常被误诊为PPI耐火性GERD.
- 使用隔膜呼吸的认知行为疗法 (CBT) 是推的第一线治疗方法.
结论:
- 提高对过度SGB和RS的认识对于准确的诊断和管理至关重要.
- 将这些行为性DGBI与GERD区分开来,对于引导治疗向CBT等心理干预措施至关重要.
- 同时出现的饮食障碍或其他DGBI可能会使管理复杂化,需要量身定制的治疗方法.
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