慢性非传染性腹:一篇综述
Prashant Singh1, Allen Lee1, Neil M Sheth1
1Division of Gastroenterology & Hepatology, Department of Internal Medicine, Michigan Medicine, Ann Arbor.
JAMA
|March 2, 2026
概括
慢性腹影响数以百万计的人,通常是由于IBS-D等非传染性原因引起的. 诊断包括排除乳病,IBD和微观结肠炎,治疗包括改变生活方式和药物.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 慢性腹,定义为持续超过4周,影响6-7%的美国成年人,超过90%的非传染性原因.
- 常见的非传染性病因包括腹刺激性肠综合征 (IBS-D) 和功能性腹,其特点是腹痛和便特征.
研究的目的:
- 概述慢性非传染性腹的常见原因,诊断方法和治疗策略.
- 强调区分针对性治疗的各种原因的重要性.
主要方法:
- 常见原因的综述:IBS-D,功能性腹,腹病,小肠细菌过度生长,胆酸腹和微观大肠炎.
- 诊断方面的考虑包括血清学检测胆固醇病,便calprotectin炎症性肠道疾病,和结肠镜与活检微观结肠炎.
- 在特定的患者群体中,建议对结直肠癌进行评估.
主要成果:
- 当特定的有机原因未被确定时,IBS-D和功能性腹是最常见的诊断.
- 微观性结肠炎在13%的慢性腹病例中在结肠活检时被发现.
- 治疗干预措施,包括生活方式修改和药物治疗,可以改善50-80%的患者的症状.
结论:
- 慢性腹的关键差异诊断包括IBS-D,功能性腹,腹,炎症性肠病和微观性结肠炎.
- 系统的诊断方法对于有效的管理至关重要.
- 用生活方式调整,饮食改变或药物治疗的经验治疗可以显著缓解症状.
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