神经系统疾病中的胃肠道动力障碍。

Gastrointestinal motility disorders in neurologic disease.

出版信息

J Clin Invest. 2021 Feb 15;131(4). doi: 10.1172/JCI143771.

Abstract

The extrinsic and autonomic nervous system intricately controls the major functions of the gastrointestinal tract through the enteric nervous system; these include motor, secretory, sensory, storage, and excretory functions. Disorders of the nervous system affecting gastrointestinal tract function manifest primarily as abnormalities in motor (rather than secretory) functions. Common gastrointestinal symptoms in neurologic disorders include sialorrhea, dysphagia, gastroparesis, intestinal pseudo-obstruction, constipation, diarrhea, and fecal incontinence. Diseases of the entire neural axis ranging from the cerebral hemispheres to the peripheral autonomic nerves can result in gastrointestinal motility disorders. The most common neurologic diseases affecting gastrointestinal function are stroke, parkinsonism, multiple sclerosis, and diabetic neuropathy. Diagnosis involves identification of the neurologic disease and its distribution, and documentation of segmental gut dysfunction, typically using noninvasive imaging, transit measurements, or intraluminal measurements of pressure activity and coordination of motility. Apart from treatment of the underlying neurologic disease, management focuses on restoration of normal hydration and nutrition and pharmacologic treatment of the gut neuromuscular disorder.

摘要

外分泌和自主神经系统通过肠神经系统错综复杂地控制胃肠道的主要功能; 这些功能包括运动、分泌、感觉、储存和排泄功能。影响胃肠道功能的神经系统疾病主要表现为运动(而非分泌)功能异常。神经系统疾病中的常见胃肠道症状包括流涎、吞咽困难、胃轻瘫、假性肠梗阻、便秘、腹泻和粪便失禁。从大脑半球到周围自主神经的整个神经轴的疾病都可能导致胃肠道动力障碍。最常见的影响胃肠道功能的神经系统疾病是中风、帕金森病、多发性硬化症和糖尿病性神经病。诊断包括识别神经系统疾病及其分布,并记录肠道功能障碍的节段,通常使用非侵入性成像、传输测量或腔内压力活动和运动协调性的测量。除了治疗基础神经系统疾病外,治疗重点还在于恢复正常的水合和营养以及肠道神经肌肉疾病的药物治疗。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索