与小麦相关的胃肠道疾病:叙述性审查
Umael Khan1, Gülen Arslan Lied1,2,3
1Section of Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway.
越来越多的人认识到小麦和质不耐受,包括乳病 (CD),小麦过敏和非乳性小麦敏感性 (NCWS). NCWS缺乏明确的机制,可能涉及nocebo效应,将其与CD和小麦过敏区分开来.
科学领域:
- 胃肠道学和免疫学
- 饮食不耐受 饮食不耐受
- 与小麦和质相关的疾病
背景情况:
- 越来越多的公众和科学家对小麦和质不耐症的兴趣.
- 病 (CD) 和小麦过敏是明确的疾病,已知机制和诊断.
- 非乳性小麦敏感性 (NCWS) 是一个有争议的类别,缺乏明确的病理生理学.
研究的目的:
- 审查与小麦有关的疾病的流行病学,病因学,临床表现,诊断和管理.
- 要区分乳病,小麦过敏和非乳性小麦敏感性.
- 探索NCWS有争议的性质和潜在的机制.
主要方法:
- 对流行病学数据的文献综述.
- 分析病因因素和提出的机制.
- 诊断标准和临床表现的总结.
- 目前管理策略的概述.
主要成果:
- 疾病和小麦过敏已经建立了诊断途径.
- NCWS诊断是基于症状排除和对质戒断的反应.
- 双盲安慰剂对照试验表明NCWS中存在显著的nocebo成分.
- NCWS可能会重叠或是刺激性肠综合征的一种形式.
结论:
- 了解CD,小麦过敏和NCWS的独特特征对于准确诊断至关重要.
- 需要进一步的研究来阐明NCWS的病理生理学.
- 管理策略应根据具体情况量身定制,考虑到心理因素在NCWS中的潜在作用.
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