Whitehead W E
Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Consult Clin Psychol. 1992 Aug;60(4):605-12. doi: 10.1037//0022-006x.60.4.605.
Behavioral research in gastroenterology has grown exponentially over the last decade. Controlled studies demonstrate that psychotherapy, stress management, and hypnosis are effective for irritable bowel syndrome; and behavioral treatments are preferred over medical management for some types of fecal incontinence and vomiting. For peptic ulcer disease, interest in behavioral treatments has declined. However, a new syndrome, functional dyspepsia, is now recognized, in which ulcerlike symptoms occur without ulcer and frequently in association with psychological symptoms. For inflammatory bowel disease, stress management training has produced inconsistent outcomes. Newly recognized disorders for which behavioral treatments are needed include constipation associated with inability to relax the pelvic floor muscles during defecation, functional rectal pain (proctalgia), noncardiac chest pain, and aerophagia (excessive air swallowing).
在过去十年中，胃肠病学领域的行为研究呈指数级增长。对照研究表明，心理治疗、压力管理和催眠对肠易激综合征有效；对于某些类型的大便失禁和呕吐，行为治疗比药物治疗更受青睐。对于消化性溃疡疾病，人们对行为治疗的兴趣有所下降。然而，现在认识到一种新的综合征——功能性消化不良，即出现类似溃疡的症状但无溃疡，且常伴有心理症状。对于炎症性肠病，压力管理训练的效果并不一致。新认识到的需要行为治疗的疾病包括排便时盆底肌肉无法放松导致的便秘、功能性直肠疼痛（直肠痛）、非心源性胸痛和气吞症（过度吞气）。
