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Clin Gastroenterol H:研究发现肠易激综合征的一种新形式

  1. 肠易激综合征

来源:生物谷 2013-09-09 21:08

2013年9月10日讯 /生物谷BIOON/--近日,加州大学洛杉矶分校研究人员描述了一种新形式的肠易激综合征(IBS),其发生于急性憩室炎之后,这一发现可能有助于更好地诊断患者的症状、减轻患者疾病痛苦。

2013年9月10日讯 /生物谷BIOON/--近日,加州大学洛杉矶分校研究人员描述了一种新形式的肠易激综合征(IBS),其发生于急性憩室炎之后,这一发现可能有助于更好地诊断患者的症状、减轻患者疾病痛苦。

加州大学洛杉矶分校David Geffen医学院医学副教授Brennan Spiegel博士说:新发现的疾病类型被称为憩室后肠易激综合症(PDV- IBS),许多肠易激症状患者会报告称有一阵子会经历憩室的发生,但是许多医生认为此情况只是原来疾病状态的一部分。

有些人患上憩室炎后,他们有复发性腹痛,腹部绞痛和腹泻,这些新的症状是他们以前没有的。已经普遍的理论是,一但憩室炎被治愈,它将从此消失。但研究已经表明,IBS症状发生于憩室后,它可能会导致炎症过程,像一颗残留在体内的炸弹,损害机体。

这项研究发表在2013年9月5日Clinical Gastroenterology and Hepatology杂志上。随着他们衰老,大多数人会罹患憩室。超过50%的60岁以上的人会具备这种疾病,但憩室通常不会引起任何问题。有时候,憩室发炎会导致憩室炎,这会导致腹部疼痛和感染。

医生通常用抗生素进行治疗,或在更严重的情况下使用手术。在新的研究中一个重大的惊喜是,憩室炎患者不仅比对照组以更高的比例罹患IBS,同时他们罹患抑郁和焦虑等情绪障碍的比率也较高。

因为IBS和情绪障碍往往齐头并进,这表明急性憩室炎甚至可能导致脑-肠轴的长期变化。PDV-IBS的发现可能意味着需要更好的注意患者憩室炎症状,特备是一些可能已经被医生忽视的症状。

Spiegel说:这项研究扩展了我们对什么可能导致肠易激综合征的理解。我们现在已经增加了IBS发展的一个新的危险因素。通过进一步研究,也许能够完善对这些患者的治疗。(生物谷Bioon.com)

Increased Risk for Irritable Bowel Syndrome After Acute Diverticulitis

, Garth Fuller, Roger Bolus, Rusha Modi, Michelle Vu, Kamyar Shahedi, Rena Shah, Mary Atia, Nicole Kurzbard, Victoria Sheen, Nikhil Agarwal, Marc Kaneshiro, Linnette Yen, Paul Hodgkins, M. Haim Erder, Brennan Spiegel

Background & AIMS
Individuals with diverticulosis frequently also have irritable bowel syndrome (IBS), but there are no longitudinal data to associate acute diverticulitis with subsequent IBS, functional bowel disorders, or related emotional distress. In patients with postinfectious IBS, gastrointestinal disorders cause long-term symptoms, so we investigated whether diverticulitis might lead to IBS. We compared the incidence of IBS and functional bowel and related affective disorders among patients with diverticulitis.

Methods
We performed a retrospective study of patients followed up for an average of 6.3 years at a Veteran's Administration medical center. Patients with diverticulitis were identified based on International Classification of Diseases, 9th revision codes, selected for the analysis based on chart review (cases, n = 1102), and matched with patients without diverticulosis (controls, n = 1102). We excluded patients with prior IBS, functional bowel, or mood disorders. We then identified patients who were diagnosed with IBS or functional bowel disorders after the diverticulitis attack, and controls who developed these disorders during the study period. We also collected information on mood disorders, analyzed survival times, and calculated adjusted hazard ratios.

Results
Cases were 4.7-fold more likely to be diagnosed later with IBS (95% confidence interval [CI], 1.6–14.0; P = .006), 2.4-fold more likely to be diagnosed later with a functional bowel disorder (95% CI, 1.6–3.6; P < .001), and 2.2-fold more likely to develop a mood disorder (CI, 1.4–3.5; P < .001) than controls.

Conclusions
Patients with diverticulitis could be at risk for later development of IBS and functional bowel disorders. We propose calling this disorder postdiverticulitis IBS. Diverticulitis appears to predispose patients to long-term gastrointestinal and emotional symptoms after resolution of inflammation; in this way, postdiverticulitis IBS is similar to postinfectious IBS.

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