Spiller Robin
Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK.
F1000Res. 2016 Apr 29;5. doi: 10.12688/f1000research.7992.1. eCollection 2016.
Despite being one of the most common conditions leading to gastroenterological referral, irritable bowel syndrome (IBS) is poorly understood. However, recent years have seen major advances. These include new understanding of the role of both inflammation and altered microbiota as well as the impact of dietary intolerances as illuminated by magnetic resonance imaging (MRI), which has thrown new light on IBS. This article will review new data on how excessive bile acid secretion mediates diarrhea and evidence from post infectious IBS which has shown how gut inflammation can alter gut microbiota and function. Studies of patients with inflammatory bowel disease (IBD) have also shown that even when inflammation is in remission, the altered enteric nerves and abnormal microbiota can generate IBS-like symptoms. The efficacy of the low FODMAP diet as a treatment for bloating, flatulence, and abdominal discomfort has been demonstrated by randomized controlled trials. MRI studies, which can quantify intestinal volumes, have provided new insights into how FODMAPs cause symptoms. This article will focus on these areas together with recent trials of new agents, which this author believes will alter clinical practice within the foreseeable future.
尽管肠易激综合征（IBS）是导致胃肠病转诊的最常见病症之一，但人们对其了解甚少。然而，近年来取得了重大进展。这些进展包括对炎症和微生物群改变的作用有了新的认识，以及磁共振成像（MRI）揭示的饮食不耐受的影响，这为肠易激综合征带来了新的启示。本文将回顾关于过量胆汁酸分泌如何介导腹泻的新数据，以及感染后肠易激综合征的证据，该证据表明肠道炎症如何改变肠道微生物群和功能。对炎症性肠病（IBD）患者的研究还表明，即使炎症处于缓解期，肠道神经改变和微生物群异常也会产生类似肠易激综合征的症状。随机对照试验已证明低FODMAP饮食对腹胀、肠胃胀气和腹部不适的治疗效果。MRI研究可以量化肠道容积，为FODMAPs如何引起症状提供了新的见解。本文将关注这些领域以及新药物的近期试验，作者认为这些试验将在可预见的未来改变临床实践。
