Pohl Daniel, Vavricka Stephan, Fox Mark, Madisch Ahmed, Studerus Diana, Wiesel Paul, Heinrich Henriette, Linas Ioannis, Schoepfer Alain, Schwizer Alexandra, Wildi Stephan
Klinik für Gastroenterologie und Hepatologie, Universitätsspital Zürich, Schweiz.
Zentrum Gastroenterologie und Hepatologie, Zürich, Schweiz.
Praxis (Bern 1994). 2023 Apr;112(5-6):304-316. doi: 10.1024/1661-8157/a003988.
Frequent Gastro-Intestinal Disorders: Management of Functional Dyspepsia and Irritable Bowel Syndrome in Clinical Practice Functional dyspepsia (FD) and irritable bowel syndrome (IBS), two common gastrointestinal entities with overlapping symptoms, should be diagnosed according to Rome IV criteria. This includes one or more of the following symptoms: in FD, postprandial fullness, early satiation, epigastric pain or burning; in IBS, recurrent abdominal pain associated with defecation, change in frequency of stool or form of stool. To exclude structural diseases, attention should be paid to alarm symptoms. As far as treatment is concerned, a stepwise scheme proves to be effective for both diseases. Step 1: doctor-patient discussion with explanation of diagnosis and prognosis as well as clarification of therapy goals; lifestyle adaptations; use of phytotherapeutics; step 2: symptom-oriented medication: for FD, PPIs or prokinetics; for IBS, antispasmodics, secretagogues, laxatives, bile acid sequestrants, antidiarrheals, antibiotics, probiotics; step 3: visceral analgesics (antidepressants).
临床实践中功能性消化不良和肠易激综合征的管理 功能性消化不良（FD）和肠易激综合征（IBS）是两种症状重叠的常见胃肠道疾病，应根据罗马IV标准进行诊断。这包括以下一种或多种症状：在FD中，餐后饱胀、早饱、上腹部疼痛或烧灼感；在IBS中，与排便相关的反复腹痛、大便频率改变或大便形态改变。为排除结构性疾病，应注意警示症状。就治疗而言，逐步治疗方案对这两种疾病均有效。第一步：医患讨论，解释诊断和预后并明确治疗目标；调整生活方式；使用植物疗法；第二步：针对症状用药：对于FD，使用质子泵抑制剂（PPIs）或促动力药；对于IBS，使用解痉药、促分泌剂、泻药、胆汁酸螯合剂、止泻药、抗生素、益生菌；第三步：使用内脏镇痛药（抗抑郁药）。
