Begré Stefan, Fox Mark, Jordi Sebastian Bruno Ulrich, Misselwitz Benjamin
ISFOM - Institut für Stressfolgeerkrankungen und Stressmanagement, Weinbergstrasse 139, Zürich, Schweiz, 8006.
Neurologie, Departement für Klinische Forschung, Inselspital Bern, Universitätsspital Bern, Bern, Schweiz.
Inn Med (Heidelb). 2025 Feb;66(2):181-189. doi: 10.1007/s00108-024-01832-x. Epub 2025 Jan 14.
In patients with inflammatory bowel diseases (IBD), functional complaints frequently persist after the clearing of inflammation and are clinically difficult to distinguish from symptoms of inflammation. In recent years, the influence of bidirectional communication between the gut and brain on gut physiology, emotions, and behavior has been demonstrated.
What mechanisms underlie the development of functional gastrointestinal complaints in patients with irritable bowel syndrome (IBS) and IBD? What therapeutic approaches arise from this?
Narrative review.
The pathogenesis of IBS involves interactions between psychosocial factors, genetics, and microbiota as well as the central and peripheral nervous systems. The interplay between stress and visceral hypersensitivity is of central importance. Therapeutically, lifestyle changes with stress reduction and exercise alongside dietary, pharmacological, and psychotherapeutic options are useful.
The treatment of functional gastrointestinal disorders remains challenging, as pharmacological therapies are often ineffective and gut-directed psychotherapies are rarely available.
在炎症性肠病（IBD）患者中，炎症消退后功能障碍性主诉常常持续存在，临床上难以与炎症症状相区分。近年来，肠道与大脑之间的双向交流对肠道生理、情绪和行为的影响已得到证实。
肠易激综合征（IBS）和IBD患者出现功能性胃肠主诉的潜在机制是什么？由此产生了哪些治疗方法？
叙述性综述。
IBS的发病机制涉及心理社会因素、遗传学、微生物群以及中枢和外周神经系统之间的相互作用。压力与内脏高敏感性之间的相互作用至关重要。在治疗方面，通过减轻压力和锻炼来改变生活方式，同时结合饮食、药物和心理治疗方法会有所帮助。
功能性胃肠疾病的治疗仍然具有挑战性，因为药物治疗往往无效，而针对肠道的心理治疗很少可用。
