Centre for Neuroscience, Surgery and Trauma, London, UK.
honorary senior lecturer and associate registrar for public mental health, Royal London Hospital, London, UK, Centre for Neuroscience, Surgery and Trauma, London, UK and Royal College of Psychiatrists, London, UK.
Clin Med (Lond). 2021 Jan;21(1):44-52. doi: 10.7861/clinmed.2020-0980.
Functional gastrointestinal (GI) disorders (eg irritable bowel syndrome and functional dyspepsia) are very common conditions which are associated with very poor quality of life and high healthcare utilisation. They are caused by disorders of GI functioning, namely altered gut sensitivity, motility, microbiota, immune functioning and central nervous system processing. They cause chronic symptoms throughout the gut (eg pain, dyspepsia and altered bowel habit), all of which are made worse by maladaptive patient behaviours, stress and psychological comorbidity. Management involves a biopsychosocial approach involving changes in lifestyle and diet, addressing coexisting psychological comorbidity and using medication to treat underlying pathophysiology. Pharmacological treatment with antispasmodics, neuromodulators, motility agents and antidepressants is effective. Psychotherapy in motivated individuals is equally effective. Success of treatment is increased by a good doctor-patient relationship and so this needs to be taken into account during the consultation.
功能性胃肠病（GI）障碍（如肠易激综合征和功能性消化不良）是非常常见的疾病，它们与生活质量极差和高医疗保健利用率有关。它们是由 GI 功能障碍引起的，即肠道敏感性、运动、微生物群、免疫功能和中枢神经系统处理的改变。它们会在整个肠道引起慢性症状（例如疼痛、消化不良和排便习惯改变），所有这些症状都会因患者行为不当、压力和心理共病而加重。管理涉及生物心理社会方法，包括改变生活方式和饮食，解决并存的心理共病，并使用药物治疗潜在的病理生理学。使用抗痉挛药、神经调节剂、运动药物和抗抑郁药进行药物治疗是有效的。在有动力的个体中进行心理治疗同样有效。良好的医患关系会增加治疗的成功率，因此在咨询期间需要考虑到这一点。
