Spiller Robin C
Robin C. Spiller, MB BChir, MSc, MD Wolfson Digestive Diseases Centre, University Hospital, Nottingham, NG7 2UH, England.
Curr Treat Options Gastroenterol. 2007 Aug;10(4):312-21. doi: 10.1007/s11938-007-0074-3.
Irritable bowel syndrome (IBS) is a ubiquitous but heterogeneous syndrome characterized by abdominal pain and erratic bowel habits that affects 5% to 10% of the population. Although current definitions specify that there are no structural or biochemical abnormalities to account for the symptoms, there is growing evidence that in at least a subset of IBS patients, there is low-grade inflammation characterized by increased T lymphocytes and mast cells. Whether this is cause or effect is uncertain, as there is also clear evidence of bidirectional communication between the immune and nervous systems, and at least some of the mucosal changes could be secondary to psychological stress. A small percentage (6%-17%) of patients develop IBS symptoms for the first time after an acute episode of infective gastroenteritis (postinfective IBS), which appears to be directly responsible for low-grade immune activation. However, even in this group, preexisting psychological factors are as important as mucosal ones. Specific anti-inflammatory treatments have not been systematically evaluated, but there is no evidence of benefit currently.
肠易激综合征（IBS）是一种普遍存在但异质性的综合征，其特征为腹痛和排便习惯紊乱，影响着5%至10%的人群。尽管目前的定义明确指出不存在可解释这些症状的结构或生化异常，但越来越多的证据表明，至少在一部分IBS患者中，存在以T淋巴细胞和肥大细胞增多为特征的低度炎症。这是原因还是结果尚不确定，因为也有明确证据表明免疫和神经系统之间存在双向通信，并且至少一些黏膜变化可能是心理压力的继发结果。一小部分（6%-17%）患者在感染性肠胃炎急性发作后首次出现IBS症状（感染后IBS），这似乎直接导致了低度免疫激活。然而，即使在这一组患者中，先前存在的心理因素与黏膜因素同样重要。特定的抗炎治疗尚未得到系统评估，但目前尚无证据表明其有益。
