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缓解期炎症性肠病患者的慢性腹痛:临床医生面临的持续挑战。

Chronic Abdominal Pain in Patients with Inflammatory Bowel Disease in Remission: A Continuing Challenge for Clinicians.

机构信息

Department of Gastroenterology, University of British Columbia, Vancouver, V5Z 1M9, Canada.

Neurogastroenterology & GI Motility, Department of Gastroenterology, University of British Columbia, Vancouver, Canada.

出版信息

Dig Dis Sci. 2024 Dec;69(12):4336-4346. doi: 10.1007/s10620-024-08716-y. Epub 2024 Nov 13.


DOI:10.1007/s10620-024-08716-y
PMID:39537891
Abstract

Inflammatory bowel disease (IBD) is a chronic condition that includes ulcerative colitis and Crohn's disease. It is characterized by a relapsing and remitting pattern that negatively impacts quality of life (QoL). Current goals of treatment involve symptomatic, biochemical, and endoscopic remission in a treat-to-target approach. Despite effective treatment and remission of IBD, many patients report frequent and isolated abdominal pain. A wide range of etiologies exist, including surgery-related, infections, pelvic conditions, immune-related, and systemic illnesses. Disorders of the gut-brain interaction (DGBI), frequently characterized by abdominal pain, are increasingly recognized in IBD patients, including those with quiescent disease. Various mechanisms are involved and numerous non-pharmacologic and pharmacologic therapies have been proposed. Hereby, we outline the pertinent findings of the literature on management of chronic abdominal pain, focusing on quiescent IBD.

摘要

炎症性肠病(IBD)是一种慢性疾病,包括溃疡性结肠炎和克罗恩病。其特征是反复发作和缓解,对生活质量(QoL)产生负面影响。目前的治疗目标是通过靶向治疗达到症状、生化和内镜缓解。尽管 IBD 得到了有效治疗和缓解,许多患者仍报告经常出现孤立性腹痛。腹痛的病因很多,包括与手术相关的、感染性的、盆腔疾病、免疫相关的和全身性疾病。肠道-大脑相互作用紊乱(DGBI)越来越多地在 IBD 患者中被认识到,包括那些处于缓解期的患者,其特征通常为腹痛。涉及多种机制,已经提出了许多非药物和药物治疗方法。在此,我们概述了关于慢性腹痛管理的文献中的相关发现,重点关注缓解期 IBD。

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[2]
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Dig Dis Sci. 2024-1

[3]
Amitriptyline at Low-Dose and Titrated for Irritable Bowel Syndrome as Second-Line Treatment in primary care (ATLANTIS): a randomised, double-blind, placebo-controlled, phase 3 trial.

Lancet. 2023-11-11

[4]
A Systematic Review and Meta-analysis of Randomized Clinical Trials on the Prevention and Treatment of Pouchitis after Ileoanal Pouch Anastomosis.

J Gastrointest Surg. 2023-11

[5]
Physical Activity for Quiescent and Mildly Active Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.

J Can Assoc Gastroenterol. 2023-8-10

[6]
The efficacy and neural mechanism of acupuncture therapy in the treatment of visceral hypersensitivity in irritable bowel syndrome.

Front Neurosci. 2023-9-4

[7]
Lifestyle Factors Associated with Abdominal Pain in Quiescent Inflammatory Bowel Disease.

Dig Dis Sci. 2023-11

[8]
Irritable Bowel Syndrome-Like Symptoms in Quiescent Inflammatory Bowel Disease: A Practical Approach to Diagnosis and Treatment of Organic Causes.

Dig Dis Sci. 2023-11

[9]
Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

Healthcare (Basel). 2023-8-31

[10]
Cannabinoids and the Gastrointestinal Tract.

Clin Gastroenterol Hepatol. 2023-12

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