Spiller R C
Division of Gastroenterology, The Wolfson Digestive Disease Centre, University Hospital, Nottingham NG7 2UH, UK.
Best Pract Res Clin Gastroenterol. 2004 Aug;18(4):641-61. doi: 10.1016/j.bpg.2004.04.002.
The term 'Functional diseases' implies symptoms arising from an organ without overt pathology. However this is more apparent than real since inflammation often leaves changes in nerves and mucosal function only apparent with specialised techniques. Acute onset functional dyspepsia accounts for around 1/5 of functional dyspepsia and is characterised by early satiety, nausea, vomiting and weight loss. Impaired postcibal fundal accommodation may underlie some of these symptoms. Post infectious gastroparesis is much rarer and is associated with markedly delayed gastric emptying and antral hypomotility. Approximately 1/10 of IBS cases describe a post infectious onset. Post infectious IBS is typically of the diarrhoea-predominant type. Post inflammatory functional diseases tend to be associated with less psychological abnormalities and have a better prognosis than other functional diseases. There are isolated anecdotal reports of symptom response to anti-inflammatory treatments but larger controlled trials are needed.
“功能性疾病”一词指的是器官出现症状但无明显病理改变。然而，这更多是表面现象而非实际情况，因为炎症常常会在神经和黏膜功能上留下变化，只是这些变化只有通过专业技术才能显现出来。急性起病的功能性消化不良约占功能性消化不良的五分之一，其特征为早饱、恶心、呕吐和体重减轻。餐后胃底容受性受损可能是其中一些症状的潜在原因。感染后胃轻瘫则更为罕见，与胃排空明显延迟和胃窦动力不足有关。约十分之一的肠易激综合征（IBS）病例描述为感染后起病。感染后IBS通常以腹泻型为主。炎症后功能性疾病往往与较少的心理异常相关，且预后比其他功能性疾病更好。有个别病例报告称抗炎治疗可缓解症状，但还需要更大规模的对照试验。
