Snape W J
Bowel Disease and Motility Center, Long Beach Memorial Medical Center, CA.
Rev Gastroenterol Mex. 1994 Apr-Jun;59(2):127-32.
In the irritable bowel syndrome gastrointestinal tract motility is disturbed from the esophagus to the colon, causing pain and altered function. When colonic motility is abnormal, the patient can experience either constipation or diarrhea in addition to abdominal pain and bloating. In constipated patients the postprandial colonic motility can increase normally after eating or the colon can remain motionless. Generally propagating contractions are absent in patients with constipation predominant irritable bowel syndrome. Propagating contractions are increased in frequency in patients with diarrhea, although the phasic contractions are decreased. Questionnaires discriminate between patients with structural disease such as ulcerative colitis and patients with functional disease, however they cannot differentiate between the different subgroups of patients with constipation predominant irritable bowel syndrome. Treatment strategies are beginning to focus on the underlying pathophysiologic abnormality.
在肠易激综合征中，从食管到结肠的胃肠道运动都会受到干扰，从而导致疼痛和功能改变。当结肠运动异常时，除腹痛和腹胀外，患者还可能出现便秘或腹泻。便秘患者进食后餐后结肠运动可正常增加，也可能结肠保持不动。一般来说，以便秘为主的肠易激综合征患者不存在推进性收缩。腹泻患者的推进性收缩频率增加，尽管阶段性收缩减少。问卷调查可区分溃疡性结肠炎等结构性疾病患者和功能性疾病患者，但无法区分以便秘为主的肠易激综合征患者的不同亚组。治疗策略开始关注潜在的病理生理异常。
