Lee Joon Seong
Institute for Digestive Research, Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Yongsan-gu, Seoul, Korea.
Korean J Gastroenterol. 2006 Aug;48(2):89-96.
Gastrointestinal (GI) motility has a crucial role in the food consumption, digestion and absorption, and also controls the appetite and satiety. In obese patients, various alterations of GI motility have been investigated. The prevalence of GERD and esophageal motor disorders in obese patients are higher than those of general population. Gastric emptying of solid food is generally accelerated and fasting gastric volume especially in distal stomach is larger in obese patients without change in accommodation. Contractile activity of small intestine in fasting period is more prominent, but orocecal transit is delayed. Autonomic dysfunction is frequently demonstrated in obese patients. These findings correspond with increased appetite and delayed satiety in obese patients, but causes or results have not been confirmed. Therapeutic interventions of these altered GI motility have been developed using botulinum toxin, gastric electrical stimulation in obese patients. Novel agents targeted for GI hormone modulation (such as ghrelin and leptin) need to be developed in the near future.
胃肠动力在食物摄入、消化和吸收过程中起着关键作用,同时也控制着食欲和饱腹感。在肥胖患者中,已经对胃肠动力的各种改变进行了研究。肥胖患者中胃食管反流病(GERD)和食管运动障碍的患病率高于普通人群。肥胖患者固体食物的胃排空通常加快,空腹胃容量尤其是胃远端的胃容量较大,而胃容纳功能无变化。肥胖患者禁食期间小肠的收缩活动更为突出,但口盲肠传输延迟。肥胖患者常出现自主神经功能障碍。这些发现与肥胖患者食欲增加和饱腹感延迟相符,但病因或结果尚未得到证实。目前已针对肥胖患者开发了使用肉毒杆菌毒素、胃电刺激等对这些改变的胃肠动力进行治疗的干预措施。在不久的将来,需要开发针对胃肠激素调节(如胃饥饿素和瘦素)的新型药物。