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直觉:理解子宫内膜异位症与消化系统的关联以改善患者护理及症状控制

Gut feeling: understanding the endometriosis-digestive link to enhance patient care and symptom control.

作者信息

Bar-El Liron, Veisman Ido, Simons Madison, Delpra Courtney, King Cara R, Gubbels Ashley

机构信息

Division of Minimally Invasive Gynecologic Surgery and Medical Gynecology, OB/GYN & Women's Health Institute.

Department of Inflammation and Immunity, Lerner Research Institute.

出版信息

Curr Opin Obstet Gynecol. 2025 Aug 1;37(4):285-293. doi: 10.1097/GCO.0000000000001041. Epub 2025 May 8.

Abstract

PURPOSE OF REVIEW

Endometriosis is a chronic inflammatory condition that frequently presents with gastrointestinal (GI) symptoms that overlap with disorders such as irritable bowel syndrome, inflammatory bowel disease, and gastroparesis, leading to diagnostic delays. Recent research highlights the intricate relationship between endometriosis and gut health, including the role of microbiota, hormonal influences, and immune dysregulation. This review explored these mechanisms and their clinical implications for enhancing diagnosis and management strategies.

RECENT FINDINGS

Recent studies have suggested that hormonal fluctuations, prostaglandin dysregulation, and gut microbiota alterations contribute to GI symptoms in endometriosis. The microbiota-gut-brain axis has been implicated in disease progression, with dysbiosis influencing systemic inflammation and estrogen metabolism. Additionally, endometriotic lesions directly infiltrating the bowel can mimic GI disorders. Multidisciplinary care models, including gastroenterologists and gynecologists, are increasingly being recognized as essential for accurate diagnosis and care. Emerging therapies such as microbiome-targeted interventions, dietary modifications, and novel biomarkers offer promising avenues for improving patient outcomes.

SUMMARY

Recognizing the gut-endometriosis connection is crucial for reducing diagnostic delays and optimizing treatment strategies. Future research should focus on refining noninvasive diagnostic tools, exploring microbiome-based therapies, and enhancing interdisciplinary collaboration to improve patient care.

摘要

综述目的

子宫内膜异位症是一种慢性炎症性疾病,常伴有胃肠道(GI)症状,这些症状与肠易激综合征、炎症性肠病和胃轻瘫等疾病重叠,导致诊断延迟。最近的研究突出了子宫内膜异位症与肠道健康之间的复杂关系,包括微生物群的作用、激素影响和免疫失调。本综述探讨了这些机制及其对加强诊断和管理策略的临床意义。

最新发现

最近的研究表明,激素波动、前列腺素失调和肠道微生物群改变导致子宫内膜异位症的胃肠道症状。微生物群-肠-脑轴与疾病进展有关,生态失调影响全身炎症和雌激素代谢。此外,直接浸润肠道的子宫内膜异位病变可模拟胃肠道疾病。包括胃肠病学家和妇科医生在内的多学科护理模式越来越被认为对准确诊断和护理至关重要。微生物群靶向干预、饮食调整和新型生物标志物等新兴疗法为改善患者预后提供了有希望的途径。

总结

认识到肠道与子宫内膜异位症的联系对于减少诊断延迟和优化治疗策略至关重要。未来的研究应侧重于改进非侵入性诊断工具、探索基于微生物群的疗法以及加强跨学科合作以改善患者护理。

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