Keller J, Layer P
Medizinische Klinik, Israelitisches Krankenhaus, Orchideenstieg 14, 22297, Hamburg, Deutschland,
Internist (Berl). 2013 Nov;54(11):1337-49. doi: 10.1007/s00108-013-3379-4.
Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are the most important functional gastrointestinal diseases (FGID), and both affect about 5-15 % of the German population. The patients' symptoms are caused by disturbances of gastrointestinal (GI) motility, secretion and sensitivity. Central processing of visceral afferences is disturbed, and the course of the disease and individual symptom perception are influenced by psychosocial factors. Diagnosis of FD and IBS is based on a compatible symptom pattern, absence of alarm symptoms and exclusion of relevant differential diagnoses. The diagnosis of FD requires a normal upper GI endoscopy. Current German guidelines also demand a normal colonoscopy for diagnosis of IBS. Basic therapeutic measures include explanation of the nature of the disease and its harmlessness quo ad vitam . Individual trigger factors should be identified and eliminated if possible. Drug therapy of persisting complaints is guided by the dominant symptom.
功能性消化不良（FD）和肠易激综合征（IBS）是最重要的功能性胃肠疾病（FGID），二者在德国人群中的发病率均约为5%-15%。患者的症状由胃肠（GI）动力、分泌及敏感性紊乱所致。内脏传入神经的中枢处理过程受到干扰，疾病进程及个体症状感知受社会心理因素影响。FD和IBS的诊断基于相符的症状模式、无警示症状以及排除相关鉴别诊断。FD的诊断需要上消化道内镜检查结果正常。德国现行指南还要求结肠镜检查结果正常方可诊断IBS。基本治疗措施包括解释疾病的性质及其对生命无害。应尽可能识别并消除个体触发因素。对持续存在的症状进行药物治疗时以主要症状为指导。
