Mearin Fermín, Rey Enrique, Balboa Agustín
Instituto de Trastornos Funcionales y Motores Digestivos, Servicio de Aparato Digestivo, Centro Médico Teknon, Barcelona, España.
Servicio de Aparato Digestivo, Hospital Clínico Universitario San Carlos, Madrid, España.
Gastroenterol Hepatol. 2014 Sep;37 Suppl 3:3-13. doi: 10.1016/S0210-5705(14)70078-0.
This article discusses the studies on functional and motor gastrointestinal disorders presented at the 2014 Digestive Diseases Week conference that are of greatest interest to us. New data have been provided on the clinical importance of functional gastrointestinal disorders, with recent prevalence data for irritable bowel syndrome and fecal incontinence. We know more about the pathophysiological mechanisms of the various functional disorders, especially irritable bowel syndrome, which has had the largest number of studies. Thus, we have gained new data on microinflammation, genetics, microbiota, psychological aspects, etc. Symptoms such as abdominal distension have gained interest in the scientific community, both in terms of patients with irritable bowel syndrome and those with constipation. From the diagnostic point of view, the search continues for a biomarker for functional gastrointestinal disorders, especially for irritable bowel syndrome. In the therapeutic area, the importance of diet for these patients (FODMAP, fructans, etc.) is once again confirmed, and data is provided that backs the efficacy of already marketed drugs such as linaclotide, which rule out the use of other drugs such as mesalazine for patients with irritable bowel syndrome. This year, new forms of drug administration have been presented, including metoclopramide nasal sprays and granisetron transdermal patches for patients with gastroparesis. Lastly, a curiosity that caught our attention was the use of a vibrating capsule to stimulate gastrointestinal transit in patients with constipation.
本文讨论了在2014年消化系统疾病周会议上展示的、我们最感兴趣的关于功能性和运动性胃肠疾病的研究。会上提供了关于功能性胃肠疾病临床重要性的新数据,以及肠易激综合征和大便失禁的最新患病率数据。我们对各种功能性疾病的病理生理机制有了更多了解,尤其是肠易激综合征,针对它的研究数量最多。因此,我们获得了关于微炎症、遗传学、微生物群、心理因素等方面的新数据。腹胀等症状在科学界引起了关注,无论是肠易激综合征患者还是便秘患者。从诊断角度来看,仍在寻找功能性胃肠疾病的生物标志物,尤其是针对肠易激综合征的生物标志物。在治疗领域,再次证实了饮食对这些患者(低聚半乳糖、果聚糖等)的重要性,并提供了支持已上市药物(如利那洛肽)疗效的数据,同时排除了其他药物(如美沙拉嗪)用于肠易激综合征患者的可能性。今年,还展示了新的给药形式,包括用于胃轻瘫患者的甲氧氯普胺鼻喷雾剂和格拉司琼透皮贴剂。最后,一个引起我们注意的新奇事物是使用振动胶囊来刺激便秘患者的胃肠蠕动。