Bokic Theodor, Storr Martin, Schicho Rudolf
Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria.
Pharmacology. 2015;96(1-2):76-85. doi: 10.1159/000435816. Epub 2015 Jul 1.
Irritable bowel syndrome (IBS) is currently one of the most common disorders of the digestive system in the Western society. Almost 2 out of 10 people suffer from IBS with women being more affected than men. IBS is associated with abdominal pain, bloating and altered stool consistency and imposes a heavy burden for the affected patients.
The pathophysiology of IBS remains elusive although potential causes have been suggested, such as a deranged brain-gut signaling, hypersensitivity of visceral sensory afferent fibers, bacterial gastroenteritis, small intestinal bacterial overgrowth (SIBO), genetic alterations and food sensitivity. Targets for the pharmacotherapy of IBS include the serotonergic and opioidergic system, and the microbial population of the gut. Alternative therapies like traditional Chinese medicine have shown some success in the combat against IBS. Key Messages: Many therapeutics for the treatment of IBS have emerged in the past; however, only a few have met up with the expectations in larger clinical trials. Additionally, the multifactorial etiology of IBS and its variety of cardinal symptoms requires an individual set of therapeutics. This review provides a short overview of potential causes and current pharmacological therapeutics and of additional and alternative therapies for IBS.
肠易激综合征(IBS)是目前西方社会最常见的消化系统疾病之一。每10人中约有2人患有IBS,女性比男性受影响更严重。IBS与腹痛、腹胀和大便性状改变有关,给受影响的患者带来沉重负担。
尽管已提出一些潜在病因,如脑-肠信号紊乱、内脏感觉传入纤维超敏、细菌性肠胃炎、小肠细菌过度生长(SIBO)、基因改变和食物敏感,但IBS的病理生理学仍不清楚。IBS药物治疗的靶点包括血清素能和阿片样物质能系统以及肠道微生物群。像传统中医这样的替代疗法在对抗IBS方面已显示出一定成效。关键信息:过去出现了许多治疗IBS的疗法;然而,在大型临床试验中只有少数疗法达到预期。此外,IBS的多因素病因及其多种主要症状需要个性化的治疗方案。本综述简要概述了IBS的潜在病因、当前的药物治疗以及其他和替代疗法。