Leserman Jane, Drossman Douglas A
UNC School of Medicine, University of North Carolina at Chapel Hill, USA.
Trauma Violence Abuse. 2007 Jul;8(3):331-43. doi: 10.1177/1524838007303240.
The primary goals of this article are to review the evidence that links sexual and physical abuse and intimate partner violence (IPV) with functional gastrointestinal (GI) symptoms and disorders and to explore physiological mechanisms that might mediate these health effects. The literature cited in this review has shown strong and consistent relationships of sexual and physical abuse history and IPV with functional GI symptoms and disorders. Among patients with these disorders, abuse history is associated with worse health-related quality of life, more health care utilization, and more pain. Although research has not determined what mechanisms might account for these associations, alterations in psychophysiological and cortico-limbic pain modulatory systems have been suggested. Given the high prevalence of abuse and long-lasting health consequences, referral for psychiatric and psychological treatment makes sense for many patients with abuse history seen within medical settings.
本文的主要目标是回顾将性虐待、身体虐待和亲密伴侣暴力（IPV）与功能性胃肠（GI）症状及疾病联系起来的证据，并探讨可能介导这些健康影响的生理机制。本综述引用的文献表明，性虐待史、身体虐待史和IPV与功能性胃肠症状及疾病之间存在强烈且一致的关系。在患有这些疾病的患者中，虐待史与较差的健康相关生活质量、更多的医疗保健利用以及更多的疼痛相关。尽管研究尚未确定哪些机制可能解释这些关联，但有人提出心理生理和皮质-边缘疼痛调节系统存在改变。鉴于虐待的高发生率和长期的健康后果，对于在医疗环境中就诊的许多有虐待史的患者，转介进行精神科和心理治疗是合理的。
