Clinical Enteric Neuroscience Translational and Epidemiological Research, Mayo Clinic College of Medicine, Charlton 8-110, 200 First Street Southwest, Rochester, MN 55905, USA.
Gastroenterol Clin North Am. 2010 Sep;39(3):481-93. doi: 10.1016/j.gtc.2010.08.005.
Dyspepsia is a highly prevalent condition characterized by symptoms originating in the gastroduodenal region without underlying organic disorder. Treatment modalities include acid-suppressive drugs, gastroprokinetic drugs, Helicobacter pylori eradication therapy, tricyclic antidepressants, and psychological therapies. Irritable bowel syndrome is a multifactorial, lower functional gastrointestinal disorder involving disturbances of the brain-gut axis. The pathophysiology provides the basis for pharmacotherapy: abnormal gastrointestinal motor functions, visceral hypersensitivity, psychosocial factors, intraluminal changes, and mucosal immune activation. Medications targeting chronic constipation or diarrhea may also relieve irritable bowel syndrome. Novel approaches to treatment require approval, and promising agents are guanylate cyclase cagonists, atypical benzodiazepines, antibiotics, immune modulators, and probiotics.
消化不良是一种高发疾病,其特征为胃部和十二指肠区域出现症状,但不存在潜在器质性紊乱。治疗方法包括抑制胃酸药物、胃肠动力药物、幽门螺杆菌根除疗法、三环类抗抑郁药和心理疗法。肠易激综合征是一种多因素、低级功能性胃肠道紊乱,涉及脑-肠轴紊乱。其病理生理学为药物治疗提供了基础:胃肠道运动功能异常、内脏敏感性高、社会心理因素、腔内变化和黏膜免疫激活。针对慢性便秘或腹泻的药物也可能缓解肠易激综合征。新型治疗方法需要获得批准,有前途的药物包括鸟苷酸环化酶激动剂、非典型苯二氮䓬类药物、抗生素、免疫调节剂和益生菌。