Sato Mitsuko, Murakami Masato
First Department of Internal Medicine, Nihon University School of Medicine.
Nihon Rinsho. 2006 Aug;64(8):1495-500.
Irritable bowel syndrome (IBS) is a functional disease with good prognosis, which is diagnosed by exclusion of possible causative organic diseases. However, since the patients tend to have strong psychotic symptoms including anxiety, tension, depression, irritation and insomnia, this syndrome has to be elucidated as a psychosomatic disease. Although the symptoms are usually limited to gastrointestinal symptoms such as abdominal pain and abnormal bowel movements, many patients also manifest some kinds of psychiatric abnormalities such as hypochondria, depression, hysteria, panic disorder and posttraumatic stress disorder. Especially, the prevalence of depression is high. Therefore, use of psychotropic drugs is efficient in treating IBS. Antidepressant agents including tricyclic agents such as amitriptyline, trimipramine, imipramine, clomipramine, amoxapine and nortriptyline; tetracyclic antidepressant; antidepressants such as SSRI and SNRI; sulpiride; benzodiazepine class anxiolytic agents; tandospirone; and Chinese herbal medicine are being used. IBS is a stress-related disease. Therefore, in spite of the importance of pharmacotherapy, patients should also be instructed to avoid the stress that aggravates the symptoms in all aspects of daily life.
肠易激综合征（IBS）是一种预后良好的功能性疾病，通过排除可能的器质性病因来诊断。然而，由于患者往往有强烈的精神症状，包括焦虑、紧张、抑郁、易怒和失眠，这种综合征必须被阐明为一种身心疾病。虽然症状通常仅限于胃肠道症状，如腹痛和排便异常，但许多患者也表现出一些精神异常，如疑病症、抑郁症、癔症、惊恐障碍和创伤后应激障碍。特别是，抑郁症的患病率很高。因此，使用精神药物治疗IBS是有效的。正在使用的药物包括三环类药物如阿米替林、曲米帕明、丙咪嗪、氯米帕明、阿莫沙平和去甲替林等抗抑郁药；四环类抗抑郁药；SSRI和SNRI等抗抑郁药；舒必利；苯二氮䓬类抗焦虑药；坦度螺酮；以及中药。IBS是一种与压力相关的疾病。因此，尽管药物治疗很重要，但也应指导患者在日常生活的各个方面避免加重症状的压力。
