Longstreth George F, Drossman Douglas A
Department of Gastroenterology, Kaiser Permanente Medical Care Program, 4647 Zion Avenue, San Diego, CA 92120, USA.
Curr Gastroenterol Rep. 2002 Oct;4(5):427-34. doi: 10.1007/s11894-002-0014-2.
Irritable bowel syndrome (IBS) is a common disorder with major health status and economic effects. Symptom criteria are of paramount importance in diagnosis, but differences among the Manning, Rome I, and Rome II criteria may lead to variable identification of people with the disorder. Practice guidelines are based on evidence and, to a greater degree, on consensus; therefore, experts vary on the specifics of ordering particular diagnostic tests. There is an overlap of IBS symptoms with those of celiac sprue, and selected patients should be tested for the latter disease. Symptom confusion with biliary pain and overlap with chronic pelvic pain could contribute to the predisposition of IBS patients to undergo cholecystectomy and hysterectomy. Development and documentation of effective therapy has been difficult, but depending on the selection of subgroups, there is evidence for usefulness of smooth muscle relaxants, loperamide, and antidepressants. Various forms of psychological therapy and new serotonin-modulating agents seem especially promising. The placebo effect of the physician-patient relationship has important therapeutic benefit.
肠易激综合征（IBS）是一种常见疾病，对健康状况和经济有重大影响。症状标准在诊断中至关重要，但曼宁标准、罗马I标准和罗马II标准之间的差异可能导致对该疾病患者的识别存在差异。实践指南基于证据，在很大程度上基于共识；因此，专家们在订购特定诊断测试的具体细节上存在差异。IBS症状与乳糜泻症状有重叠，部分患者应接受后者的检测。与胆绞痛的症状混淆以及与慢性盆腔疼痛的重叠可能导致IBS患者倾向于接受胆囊切除术和子宫切除术。有效治疗方法的开发和记录一直很困难，但根据亚组的选择，有证据表明平滑肌松弛剂、洛哌丁胺和抗抑郁药是有用的。各种形式的心理治疗和新型5-羟色胺调节剂似乎特别有前景。医患关系的安慰剂效应具有重要的治疗益处。
