Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Curr Opin Gastroenterol. 2011 Jan;27(1):72-8. doi: 10.1097/MOG.0b013e3283414065.
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by abdominal discomfort or pain that is accompanied by a disturbance in defecation. Although the exact etiopathogenesis is not completely understood, recent advances in the understanding of the biochemical, physiologic, and biopsychosocial mechanisms of IBS have resulted in exciting new insights as well as therapies. This article will review the recent developments in pathogenesis, diagnosis, and treatment.
IBS may be the product of various pathogenic mechanisms which include IBS as a serotonergic disorder; the role of genetics; IBS as an inflammatory state and the potential role of mast cells; IBS as a result of bacterial overgrowth and altered gastrointestinal microbiome; and abnormal pain processing and pain memory. Emerging therapies have developed targeting these mechanisms.
IBS remains a symptom-based diagnosis that can usually be made comfortably based on clinical history without testing in the absence of alarm features. Novel and emerging therapies that are based upon the evolving understanding of the pathophysiology of IBS hold significant promise and for the first time there are potential therapies that may alter the natural history of this disorder.
肠易激综合征（IBS）是一种常见的功能性胃肠道疾病，其特征为腹部不适或疼痛，并伴有排便习惯改变。尽管确切的病因发病机制尚不完全清楚，但近年来对 IBS 的生化、生理和生物心理社会机制的理解的进展，为治疗提供了新的思路。本文将对 IBS 的发病机制、诊断和治疗的最新进展进行综述。
IBS 可能是多种致病机制的产物，包括 IBS 是一种 5-羟色胺能障碍；遗传的作用；IBS 作为一种炎症状态和肥大细胞的潜在作用；由于细菌过度生长和胃肠道微生物组改变；以及异常的疼痛处理和疼痛记忆。针对这些机制的新兴治疗方法已经出现。
IBS 仍然是一种基于症状的诊断，如果没有警报特征，通常可以根据临床病史舒适地做出诊断，而无需进行检查。基于对 IBS 病理生理学的不断发展的理解而开发的新型和新兴疗法具有很大的前景，并且首次出现了可能改变这种疾病自然史的潜在疗法。
