Vogt W
Zentrum für Endoskopie, Klinikum Esslingen, Akademisches Lehrkrankenhaus der Universität Tübingen.
Praxis (Bern 1994). 2007 Nov 21;96(47):1849-55. doi: 10.1024/1661-8157.96.47.1849.
Functional gastrointestinal disorders particularly dyspepsia an irritable bowel syndrome are frequent problems for the general practitioner and also for the specialist. Both are diseases and not only a kind of discomfort. The high frequency of dispepsia and irritable bowel syndrome induces very high direct and indirect charges. Both diseases depend on a number of factors or causes, for whom the evidence is not good. But there are good experimental data for the visceral hypersensitivity as one of the main factors. Gastroscopy is the most important examination in the diagnosis of dyspepsia. Endoscopy has to be done in all patients with alarm symptoms an in all patients older than 45 years. The therapy of dyspepsia is an empirical one. The eradication of Helicobacter pylori is a therapeutical option, but only 8% of the patients will have benefit for a long time. Other therapeutical options are the use of proton-pump inhibitors, prokinetics or phytotherapeutics. The therapy of the irritable bowel syndrome depends on the subtype of the disease (diarrhea, constipation, abdominal pain, bloating). First of all a good doctor-patient relationship is mandatory. Furthermore the use of dietary fibre, antidiarrhoeics, laxatives and muscle relaxants may be beneficial. And phytotherapeutics can be an additional therapeutic approach.
功能性胃肠疾病，尤其是消化不良和肠易激综合征，对于全科医生和专科医生来说都是常见问题。这两种都是疾病，而不仅仅是一种不适。消化不良和肠易激综合征的高发病率导致了非常高的直接和间接费用。这两种疾病取决于许多因素或病因，而关于这些因素的证据并不充分。但有充分的实验数据表明内脏高敏感性是主要因素之一。胃镜检查是诊断消化不良最重要的检查。所有有报警症状的患者以及所有45岁以上的患者都必须进行内镜检查。消化不良的治疗是经验性的。根除幽门螺杆菌是一种治疗选择，但只有8%的患者会长期受益。其他治疗选择包括使用质子泵抑制剂、促动力药或植物疗法。肠易激综合征的治疗取决于疾病的亚型（腹泻、便秘、腹痛、腹胀）。首先，良好的医患关系是必不可少的。此外，使用膳食纤维、止泻药、泻药和肌肉松弛剂可能有益。植物疗法可以是一种额外的治疗方法。
