Wang Xiao Jing, Thakur Elyse, Shapiro Jordan
Mayo Clinic Rochester, MN, USA
Atrium Health, Charlotte, NC, USA.
BMJ. 2024 Dec 16;387:e075777. doi: 10.1136/bmj-2023-075777.
Irritable bowel syndrome (IBS) is a chronic disorder of gut-brain interaction that impacts a significant portion of the population and is associated with substantial morbidity, reduced quality of life, and economic impact globally. The pathophysiology of IBS is complex and incompletely understood, and the heterogeneity of IBS is reflected in the variety of pharmaceutical and non-pharmaceutical therapies utilized for the management of IBS. Given limitations with pharmaceutical treatments, many patients with IBS seek non-pharmaceutical options. Several non-pharmaceutical treatments such as the low FODMAP diet and brain-gut behavior interventions such as gut directed hypnosis and cognitive behavioral therapy are now considered standard of care and are part of all major guidelines for the treatment of IBS. However, challenges with access to and optimal implementation of these therapies remain. This review focuses on the current evidence for common non-pharmaceutical treatments for IBS, including the latest advances in dietary and brain-gut behavioral care, in addition other complementary and integrative health practices and emerging therapies.
肠易激综合征(IBS)是一种肠道与大脑相互作用的慢性疾病,影响着相当一部分人群,在全球范围内与高发病率、生活质量下降及经济影响相关。IBS的病理生理学复杂且尚未完全明确,IBS的异质性体现在用于管理IBS的各种药物和非药物疗法中。鉴于药物治疗存在局限性,许多IBS患者寻求非药物选择。几种非药物治疗方法,如低FODMAP饮食以及肠道导向催眠和认知行为疗法等脑-肠行为干预措施,现在被视为标准治疗方法,并且是所有IBS主要治疗指南的一部分。然而,这些疗法在获取和优化实施方面仍存在挑战。本综述重点关注IBS常见非药物治疗的当前证据,包括饮食和脑-肠行为护理的最新进展,以及其他补充和综合健康实践及新兴疗法。