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罗马基金会肠道-脑互动障碍重叠问题工作小组报告

Rome Foundation Working Team Report on overlap in disorders of gut-brain interaction.

作者信息

Barbara Giovanni, Aziz Imran, Ballou Sarah, Chang Lin, Ford Alexander C, Fukudo Shin, Nurko Samuel, Olano Carolina, Saps Miguel, Sayuk Gregory, Siah Kewin T H, Van Oudenhove Lukas, Simrén Magnus

机构信息

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

出版信息

Nat Rev Gastroenterol Hepatol. 2025 Apr;22(4):228-251. doi: 10.1038/s41575-024-01033-9. Epub 2025 Jan 27.

Abstract

In patients with disorders of gut-brain interaction (DGBI), overlapping non-gastrointestinal conditions such as fibromyalgia, headaches, gynaecological and urological conditions, sleep disturbances and fatigue are common, as is overlap among DGBI in different regions of the gastrointestinal tract. These overlaps strongly influence patient management and outcome. Shared pathophysiology could explain this scenario, but details are not fully understood. This overlap has been shown to be of great relevance for DGBI. In addition, symptoms considered to be caused by a DGBI could have a detectable organic cause, and in patients with a diagnosed organic gastrointestinal disease, symptoms not clearly explained by the pathology defining this organic disease are common. Thus, the aims of this Rome Foundation Working Team Report were to review the literature on overlapping conditions among patients with paediatric and adult DGBI and, based on the available epidemiological and clinical evidence, make recommendations for the current diagnostic and therapeutic approach, and for future research. Specifically, we focused on other DGBI in the same or different gastrointestinal anatomical region(s), DGBI overlap with organic bowel diseases in remission, and DGBI overlap with non-gastrointestinal, non-structural conditions.

摘要

在肠道-脑相互作用障碍(DGBI)患者中,重叠的非胃肠道疾病很常见,如纤维肌痛、头痛、妇科和泌尿系统疾病、睡眠障碍及疲劳等,不同胃肠道区域的DGBI之间也存在重叠。这些重叠对患者的管理和预后有很大影响。共同的病理生理学可以解释这种情况,但具体细节尚未完全明了。这种重叠已被证明与DGBI密切相关。此外,被认为由DGBI引起的症状可能有可检测到的器质性病因,而在已诊断为器质性胃肠疾病的患者中,无法用定义该器质性疾病的病理学明确解释的症状也很常见。因此,本罗马基金会工作团队报告的目的是回顾有关儿童和成人DGBI患者重叠情况的文献,并根据现有的流行病学和临床证据,对当前的诊断和治疗方法以及未来的研究提出建议。具体而言,我们重点关注同一或不同胃肠道解剖区域的其他DGBI、缓解期DGBI与器质性肠道疾病的重叠,以及DGBI与非胃肠道、非结构性疾病的重叠。

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