Irritable bowel syndrome: Diagnosis and pathogenesis
Irritable bowel syndrome: Diagnosis and pathogenesis
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DOI：
10.3748/wjg.v18.i37.5151
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发表时间：
2012-10-07
影响因子：
4.3
通讯作者：
El-Salhy, Magdy
中科院分区：
文献类型：
--
作者：
El-Salhy, Magdy
肠易激综合征（IBS）是一种常见的胃肠道（GI）疾病，大大降低了生活质量。由于医疗资源的高消耗和IBS患者的非生产力，它进一步代表了社会的经济负担。IBS的诊断基于症状评估和罗马III标准。结合罗马III标准，体格检查，血液检查，胃镜检查和结肠镜检查与活检被认为是必要的诊断。十二指肠嗜铬粒蛋白A细胞密度是诊断IBS的一个有前途的生物标志物。IBS的发病机制似乎是多因素的，其中以下因素在IBS的发病机制中起核心作用：遗传性和遗传学、饮食/肠道微生物群、低度炎症和肠道神经内分泌系统（内斯）的紊乱。有一种假说认为IBS的病因是内斯酶的改变，这会导致胃肠道运动、分泌和感觉异常。所有这些异常都是IBS的特征。内斯的改变可能是以下一种或多种因素的结果：遗传因素、饮食摄入、肠道植物群或轻度炎症。感染后IBS（PI-IBS）和炎性肠病相关IBS（IBD-IBS）代表IBS病例的相当大的子集。PI-和IBD-IBS患者表现出低度粘膜炎症，以及肠道内斯异常。(C)2012年百世登。All rights reserved.
Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients. The diagnosis of IBS is based on symptom assessment and the Rome III criteria. A combination of the Rome III criteria, a physical examination, blood tests, gastroscopy and colonoscopy with biopsies is believed to be necessary for diagnosis. Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS. The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS: heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following: genetic factors, dietary intake, intestinal flora, or low-grade inflammation. Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases. Patients with PI- and IBD-IBS exhibit low-grade mucosal inflammation, as well as abnormalities in the NES of the gut. (C) 2012 Baishideng. All rights reserved.