Camilleri M, Prather C M
Gastroenterology Research Unit, Mayo Clinic, Rochester, MN 55905.
Ann Intern Med. 1992 Jun 15;116(12 Pt 1):1001-8. doi: 10.7326/0003-4819-116-12-1001.
To develop a practical strategy that facilitates the management of patients with the irritable bowel syndrome (IBS).
Review of the pertinent literature published in major English-language journals for the last 25 years, describing the pathophysiology and treatment of subgroups of patients with IBS.
A stepwise approach for practical management of patients with suspected IBS is identified. The first step includes a combination of positive diagnosis of symptoms with limited investigations to exclude underlying structural or biochemical disorders. In the second step, therapeutic trials focus on alleviating the predominant symptoms. For patients with intractable symptoms, the third step combines novel tests to assess altered function and therapeutic trials to correct the dysfunction identified in the individual patient.
A practical approach has been developed for management of IBS. It is based on advances in our understanding of the mechanisms resulting in IBS and on targeting therapy to correct the dysfunctions in these patients.
制定一种有助于管理肠易激综合征（IBS）患者的实用策略。
回顾过去25年在主要英文期刊上发表的相关文献，描述IBS患者亚组的病理生理学和治疗方法。
确定了一种对疑似IBS患者进行实际管理的逐步方法。第一步包括将症状的阳性诊断与有限的检查相结合，以排除潜在的结构或生化紊乱。第二步，治疗试验侧重于缓解主要症状。对于症状顽固的患者，第三步结合新的测试来评估功能改变，并进行治疗试验以纠正个体患者中发现的功能障碍。
已制定出一种管理IBS的实用方法。它基于我们对导致IBS的机制的理解进展以及针对这些患者的功能障碍进行靶向治疗。
