Farthing Michael J G
St George's, University of London, Cranmer Terrace, London, UK.
Curr Gastroenterol Rep. 2005 Oct;7(5):350-7. doi: 10.1007/s11894-005-0003-3.
Functional diarrhea occurs as part of the irritable bowel syndrome (IBS) and as an isolated symptom as functional (painless) diarrhea. Progress has been made in defining these disorders and in identifying new mechanisms involved in symptom production. A strong link exists between intestinal infection and IBS, as is the role of 5-hydroxytryptamine (5-HT). The importance of persistent subclinical inflammation is also emerging as a potential etiologic factor, particularly in post-infectious IBS. Although changes in the bacterial flora and bacterial overgrowth have been put forward as additional new contributors to symptom production, the case is not strong. These developments in pathogenesis have facilitated the introduction of new therapies. 5-HT(3) antagonists reduce bowel frequency and pain in women with diarrhea-predominant IBS, but their use is limited because of ischemic colitis. Prednisolone lacks efficacy, and early results with probiotics and herbal remedies are encouraging but require confirmation by larger trials.
功能性腹泻作为肠易激综合征（IBS）的一部分出现，也作为功能性（无痛性）腹泻这一孤立症状出现。在定义这些疾病以及识别症状产生所涉及的新机制方面已经取得了进展。肠道感染与IBS之间存在紧密联系，5-羟色胺（5-HT）也发挥着作用。持续性亚临床炎症作为潜在病因的重要性也日益显现，尤其是在感染后IBS中。尽管已提出细菌菌群变化和细菌过度生长是症状产生的其他新因素，但证据并不充分。这些发病机制方面的进展推动了新疗法的引入。5-HT（3）拮抗剂可减少腹泻型IBS女性的排便次数和疼痛，但由于缺血性结肠炎，其应用受到限制。泼尼松龙缺乏疗效，益生菌和草药疗法的早期结果令人鼓舞，但需要更大规模试验予以证实。
