Wienbeck M, Erckenbrecht J
Leber Magen Darm. 1982 Feb;12(1):1-7.
In patients suffering from the irritable bowel syndrome no morphological substrate for this disease can be found; thus quantitation of functional parameters might be desirable. In the colon these patients exhibit myoelectrical waves of increased frequency, e.g. 3 per minute, as well as an exaggerated retropulsion and a prolonged motor response after food intake, indicating an abnormal motility pattern. In the small gut transit is either accelerated, causing diarrhea, or slowed down, causing constipation; in addition, there is an increased retrograde movement of intestinal gas. The pain threshold is decreased in the small and large bowel; inflation of a balloon or insufflation of gas may reproduce the clinical symptoms of the patients. In the terminal ileum there is net fluid secretion instead of net absorption, as normal. Even the esophagus may be affected, since manometry has demonstrated disturbed peristalsis and a reduced pressure of the lower esophageal sphincter. Such quantification of intestinal function is not a substitute for careful clinical work-up. It has however contributed to a better understanding of the underlying functional disturbances in irritable bowel syndrome.
在患有肠易激综合征的患者中,找不到该疾病的形态学基础;因此,对功能参数进行定量分析可能是必要的。在结肠中,这些患者表现出频率增加的肌电活动,例如每分钟3次,以及进食后夸张的逆蠕动和延长的运动反应,表明存在异常的运动模式。在小肠中,运输速度要么加快导致腹泻,要么减慢导致便秘;此外,肠道气体的逆行运动增加。小肠和大肠的痛阈降低;气囊充气或气体注入可能重现患者的临床症状。在回肠末端,与正常情况相反,出现净液体分泌而非净吸收。甚至食管也可能受到影响,因为测压已证明蠕动紊乱和食管下括约肌压力降低。这种肠道功能的定量分析并不能替代仔细的临床检查。然而,它有助于更好地理解肠易激综合征潜在的功能紊乱。