Is irritable bowel syndrome an organic disorder?
Is irritable bowel syndrome an organic disorder?
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DOI：
10.3748/wjg.v20.i2.384
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发表时间：
2014-01-14
影响因子：
4.3
通讯作者：
Hausken, Trygve
中科院分区：
文献类型：
--
作者：
El-Salhy, Magdy;Gundersen, Doris;Hausken, Trygve
肠易激综合征（IBS）是一种常见的胃肠道疾病，通常被认为是功能性的，因为似乎没有相关的解剖缺陷。压力和心理因素被认为在IBS中起重要作用。肠神经内分泌系统（内斯）调节胃肠道的所有功能，由分散在粘膜上皮细胞中的内分泌细胞和肠神经系统组成。虽然肠内斯能够独立于中枢神经系统（CNS）运行，但其与CNS相连并受CNS调节。本文综述了IBS患者存在解剖缺陷的证据，即在胃肠道内分泌细胞中。这些细胞具有特化的微绒毛，其投射到管腔中并充当管腔内容物的传感器，并通过将激素释放到固有层中来响应管腔刺激，这开始了在整个内斯中进行的连锁反应。在IBS患者中观察到的胃肠道内分泌细胞的变化与IBS患者中报告的其他异常高度一致，例如内脏高敏感性、运动障碍和分泌异常。(c)2014百世登出版集团有限公司有限公司All rights reserved.
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that is generally considered to be functional because there appears to be no associated anatomical defect. Stress and psychological factors are thought to play an important role in IBS. The gut neuroendocrine system (NES), which regulates all functions of the gastrointestinal tract, consists of endocrine cells that are scattered among the epithelial cells of the mucosa, and the enteric nervous system. Although it is capable of operating independently from the central nervous system (CNS), the gut NES is connected to and modulated by the CNS. This review presents evidence for the presence of an anatomical defect in IBS patients, namely in the gastrointestinal endocrine cells. These cells have specialized microvilli that project into the lumen and function as sensors for the luminal content and respond to luminal stimuli by releasing hormones into the lamina propria, which starts a chain reaction that progresses throughout the entire NES. The changes in the gastrointestinal endocrine cells observed in IBS patients are highly consistent with the other abnormalities reported in IBS patients, such as visceral hypersensitivity, dysmotility, and abnormal secretion. (c) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.