Astegiano M, Pellicano R, Sguazzini C, Berrutti M, Simondi D, Reggiani S, Rizzetto M
Unit of Gastro-epatology, San Giovanni Battista Hospital, Turin, Italy.
Minerva Gastroenterol Dietol. 2008 Sep;54(3):251-7.
Irritable bowel syndrome (IBS), as defined by Rome III diagnostic criteria, affects 10-20% of the general population, with women 20-40 years old accounting for the majority of patients. Although variable and intermittent, IBS symptoms may persist for many years. Repeated referrals for medical consultation and diagnostic studies generate huge healthcare costs. Since there is no evidence that IBS leads to more severe gastrointestinal disorders, in absence of alarm symptoms or signs, an invasive diagnostic algorithm is not indicated. Optimal treatment for IBS still needs to be defined. The clinical approach is based on treatment of the prevalent symptom. When pain predominates, antispasmodics are the first choice. In case of diarrhea, loperamide is useful for reducing bowel frequency. Soluble fiber represents the first option in subjects with IBS and constipation or mixed IBS. Dietary integrators composed of probiotics and serotonin precursors are a promising therapeutic option.
根据罗马III诊断标准定义，肠易激综合征（IBS）影响着10%至20%的普通人群，其中20至40岁的女性患者占大多数。尽管IBS症状多变且间歇性发作，但可能会持续多年。反复寻求医疗咨询和诊断检查会产生巨大的医疗费用。由于没有证据表明IBS会导致更严重的胃肠道疾病，在没有警示症状或体征的情况下，不建议采用侵入性诊断方法。IBS的最佳治疗方案仍有待确定。临床治疗方法基于对主要症状的治疗。当疼痛为主时，解痉药是首选。腹泻时，洛哌丁胺有助于减少排便次数。对于患有IBS且伴有便秘或混合型IBS的患者，可溶纤维是首选。由益生菌和血清素前体组成的膳食补充剂是一种有前景的治疗选择。
