Talley Nicholas J
Clinical Enteric Neuroscience Translational and Epidemiological Research Program, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Rev Gastroenterol Disord. 2006 Spring;6(2):72-8.
The functional gastrointestinal disorders are defined by the Rome criteria as a heterogeneous group of symptom-based conditions that have no structural or biochemical explanation. However, this definition now seems outdated, because structural and molecular abnormalities have begun to be recognized in subsets of patients with the irritable bowel syndrome (IBS), the prototypic functional bowel disease. A complex classification system based arbitrarily on symptom criteria does not fit in with a number of emerging facts. For example, the symptom overlap of IBS with gastroesophageal reflux disease is not due to chance, and the emergence of post-infectious IBS, dyspepsia, or both after Salmonella gastroenteritis fits better with a 1-disease model. A new paradigm seems to be needed. All of these disorders may arise after infection or gut inflammation, but the phenotype depends on localized neuromuscular dysfunction in the predisposed human host (the "irritable gut").
功能性胃肠疾病根据罗马标准被定义为一组基于症状的异质性疾病，不存在结构或生化方面的解释。然而，这一定义现在似乎过时了，因为在肠易激综合征（IBS）患者亚组中已开始认识到结构和分子异常，IBS是典型的功能性肠病。基于症状标准任意制定的复杂分类系统与一些新出现的事实并不相符。例如，IBS与胃食管反流病的症状重叠并非偶然，沙门氏菌性胃肠炎后感染后IBS、消化不良或两者并发的情况更符合单一疾病模型。似乎需要一种新的范式。所有这些疾病可能在感染或肠道炎症后出现，但其表型取决于易感人类宿主（“易激肠道”）中的局部神经肌肉功能障碍。
