患有不活跃炎症性肠病的患者的持续腹痛:临床难题
Alessandra Dell'Era1, Elisabetta Antonelli2, Fotios S Fousekis3
1Gastroenterology Unit, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan, Milan, Italy.
患有非活性炎症性肠病的患者通常会因为肠-大脑轴失调而经历持续的腹痛,而不是持续的炎症. 本综述探讨了多因素原因,并倡导生物心理社会治疗方法.
科学领域:
- 胃肠病学 胃肠病学
- 神经胃肠病学 神经胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 炎症性肠病 (IBD) 可以破坏肠道平衡,导致持续的腹部症状,即使在活跃的炎症消失后.
- 显著的百分比的IBD患者在缓解期间报告类似于刺激性肠综合征 (IBS) 的症状.
研究的目的:
- 审查和批判性地检查IBD缓解中的持续腹痛的文献.
- 探索这些症状背后的多因素病理生理学.
- 强调需要全面的诊断和治疗方法.
主要方法:
- 文献审查和对相关研究的批判性审查.
主要成果:
- 持续的症状显著损害了生活质量,并且经常导致残疾.
- 识别这些症状的根本原因可能是具有挑战性的.
结论:
- 新出现的证据表明复杂的相互作用,包括内脏过敏,肠道神经系统变化,中心敏感化,肠-大脑轴调节失调以及心理社会因素.
- 这些因素导致IBD缓解的疼痛,而不是持续的粘膜炎症.
- 一种全面的生物心理社会方法对于诊断和治疗至关重要.
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