Zespół jelita nadwrażliwego – wspólny problem, indywidualne podejście Artykuł przeglądowy
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Opublikowane:
gru 31, 2021
Słowa kluczowe:
zespół jelita nadwrażliwego, dysbioza, leczenie IBS, leki rozkurczowe, antydepresanty
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Abstrakt
Zespół jelita nadwrażliwego charakteryzuje się nawracającym bólem brzucha występującym co najmniej raz w tygodniu przez ostatnie 3 miesiące, przy wystąpieniu objawów co najmniej 6 miesięcy wcześniej, związanych z co najmniej dwiema cechami: wypróżnieniem, zmianą częstości wypróżnień, zmianą wyglądu stolca. Według Kryteriów rzymskich IV chorobę stwierdza się na podstawie objawów klinicznych. Nie dotyczy to osób po 50. r.ż. (a w przypadku krewnych pierwszego stopnia pacjentów z rakiem jelita grubego po 45. r.ż.) oraz z objawami alarmowymi. Ze względu na brak jednego czynnika etiologicznego leczenie zespołu jelita nadwrażliwego polega na zmniejszeniu nasilenia symptomów i poprawie jakości życia chorego. Postępowanie niefarmakologiczne obejmuje dietę bogatą w błonnik i modyfikację mikrobioty. W ramach farmakoterapii najskuteczniejsze są leki rozkurczowe stosowane bezpośrednio na mięśniówkę gładką, hamujące napływ wapnia, takie jak: drotaweryna, mebeweryna i alweryna. Wykazano również skuteczność leków przeciwdepresyjnych, co potwierdza, że zaburzenia czynnościowe przewodu pokarmowego są manifestacją dysfunkcji osi mózg–jelito–mikrobiota.
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Jak cytować
Skrzydło-Radomańska , B., & Sapilak, B. J. (2021). Zespół jelita nadwrażliwego – wspólny problem, indywidualne podejście. Medycyna Faktów , 14(4(53), 369-374. https://doi.org/10.24292/01.MF.0421.5
Numer
Dział
Artykuły
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Bibliografia
1. Drossman D. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology. 2016; 150: 1262-79.
2. Canon M, Ruiz A, Rondon M et al. Prevalence of irritable bowel syndrome and health related quality of life in adults aged 18 to 30 years in a Colombian University: an elecrtronic survey. Am J Gastroenterol. 2017; 30: 67-75.
3. Sperber A, Dumitrascu D, Fukudo S et al. The global prevalence of IBS in adults remains elusive due to heterogeneity of studies: a Rome Foundation working team literature review. Gut. 2017; 66: 1075-82.
4. Klem F, Wadhwa A, Prokop L et al. Prevalence, risk factors and outcomes of irritable bowel syndrome after infectious enteritis: a systematic review and meta-analysis. Gastroenterology. 2017; 152: 1042-54.
5. Oshima T, Siah KT, Yoshimoto T et al. Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: a population- base survey. J Gastroenterol Hepatol. 2020; 36(7): 1820-7. http://doi.org/10.1111/jgh.15346.
6. Ciechanowicz P, Lewandowski K, Szymańska E et al. Skin and gastrointestinal symptoms in COVID-19. Gastroenterology Rev. 2020; 15(4): 301-8.
7. Blackett JW, Li J, Jodorovsky D et al. Prevalence and risk factors for gastrointestinal symptoms after recovery from COVID-19. Neurogastroenterol Motility. 2021. http://doi.org/10.1111/nmo.14251 .
8. Chen B, Kim J, Zhang Y et al. Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J Gastroenterol. 2018; 53(7): 807-18. http://doi.org/10.1007/s00535-018-1476-9.
9. Barbara G, Feinle-Bisset C, Ghoshal U et al. The intestinal microenvironment and functional gastrointestinal disorders. Gastroenterology. 2016; 150: 1305-18.
10. Weaver K, Sherwin L, Wallit B et al. Neuroimaging the brain-gut axis in petientes with irritable bowel syndrome. World J Gastrointest Pharmacol Ther. 2016; 7: 320-33.
11. Van Oudenhove L, Levy R, Crowlel M et al. Biopsychosocial aspects of functional gastrointestinal disorders: how central and environmental processes contribute to the development and expression of functional gastrointestinal disorders. Gastroenterology. 2016; 150: 1355-67.
12. Qin H, Cheng C, Tang X et al. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014; 20: 14126-31.
13. Pietrzak A, Skrzydło-Radomańska B, Mulak A et al. Rekomendacje diagnostyczno-terapeutyczne w zespole jelita nadwrażliwego. Gastroenterol Rev. 2018; 13(4): 2-30.
14. Lacy B, Mearin F, Chang L et al. Bowel disorders. Gastroenterology. 2016; 150: 1393-407.
15. Aasbrenn M, Lydersen S, Farup P. A conservative weight loss intervention relieves bowel symptoms in morbidly obese subjects with irritable bowel syndrome: a prospective cohort study. J Obes. 2018; 18: 3732-753.
16. Laird K, Tanner-Smith E, Russell A et al. Comparative efficacy of psychological therapies for irritable bowel syndrome: a systematic review and meta-analysis. Clin Psychol Rev. 2017; 51: 142-52.
17. Black Ch, Staudacher HM, Ford AC. Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analyzis. Gut. 2021; 0: 1-10. http://doi.org/10.1136/gutjnl-2021-325214.
18. Hou X, Chen S, Zhang Y et al. Quality of life in patients with irritable bowel syndrome assessed using IBS-QoL measure after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide: results of an international prospective observational cohort study in Poland, Egypt, Mexico and China. Clin Drug Investig. 2014; 34(11): 783-93.
19. Kruis W, Weinzierl M, Schlusser P et al. Comparison of therapeutic effects of wheat brain, mebeverine and placebo in patients with the irritable bowel syndrome. Digestion. 1986; 34: 196-201.
20. Vahedi H, Merat S, Momtahen S et al. Clnical trial: the effect of amitriptyline in patients with diarrhea-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2008; 27: 678-84.
21. Tack J, Broekaert D, Fischler B et al. A controlled crossover study of the selective serotonin reuptake inhibitors citalopram in irritable bowel syndrome. Gut. 2006; 55: 1095-103.
22. Talley NJ, Kellow JE, Boyce P et al. Antidepressant therapy (imipramine and citalopram) for irritable bowel syndrome: a double-blind, randomized, placebo-controlled trial. Dig Dis Sci. 2008; 53; 108-15.
23. Pimentel M, Lembo A, Chey W et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011; 363: 22-32.
24. Lembo A, Pimentel M, Rao S et al. Repeat treatment with rifaximin is safe and effective in patients with diarhhea-predominant irritable bowel syndrome. Gastroenterology. 2016; 151: 1113-21.
25. Begtrup LM, de Muckadell OB, Kjedsen J et al. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome – a randomized, double-blind, placebo controlled trial. Scand J Gastroenterol. 2013; 48: 1127-35.
26. Efskind PS, Bernklev T, Vatn MH. A double-blind placebo-controlled trial with loperamide in irritable bowel syndrome. Scand J Gastroenterol. 1996; 31: 463-8.
27. Award RA, Camacho S. A randomized double-blind placebo-controlled trial of polyethylene glycol effects on fasting and postprandial rectal sensitivity and symptoms in hypersensitive constipation-predominant irritable bowel syndrome. Colorectal Dis. 2010; 12: 1131-8.
28. Lam C, Tan W, Yu J et al. A mechanistic multicentre, parallel group, randomized placebo-controlled trial of mesalazine for the treatment of IBS with diarrhea (IBS-D). Gut. 2016; 65: 91-9.
29. Sperber AD, Dumitrascu D, Fukudo S et al. The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. Gut. 2017; 66(6): 1075-82.
30. Skrzydło-Radomańska B. Zespół jelita drażliwego. Med Prakt. 2020; 4: 134-8.
31. Bueno-Notivol J, Gracia-García P, Olaya B et al. Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. Int J Clin Health Psychol. 2021; 21(1): 100196. http://doi.org/10.1016/j.ijchp.2020.07.007.
32. Hossain MM, Rahman M, Trisha NF et al. Prevalence of anxiety and depression in South Asia during COVID-19: a systematic review and meta-analysis. Heliyon. 2021; 7(4): e06677.
33. Gilbody JS, Fletcher CP, Hughes IW et al. Comparison of two different formulations of mebeverine hydrochloride in irritable bowel syndrome. Int J Clin Pract. 2000; 54: 461-4.
2. Canon M, Ruiz A, Rondon M et al. Prevalence of irritable bowel syndrome and health related quality of life in adults aged 18 to 30 years in a Colombian University: an elecrtronic survey. Am J Gastroenterol. 2017; 30: 67-75.
3. Sperber A, Dumitrascu D, Fukudo S et al. The global prevalence of IBS in adults remains elusive due to heterogeneity of studies: a Rome Foundation working team literature review. Gut. 2017; 66: 1075-82.
4. Klem F, Wadhwa A, Prokop L et al. Prevalence, risk factors and outcomes of irritable bowel syndrome after infectious enteritis: a systematic review and meta-analysis. Gastroenterology. 2017; 152: 1042-54.
5. Oshima T, Siah KT, Yoshimoto T et al. Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: a population- base survey. J Gastroenterol Hepatol. 2020; 36(7): 1820-7. http://doi.org/10.1111/jgh.15346.
6. Ciechanowicz P, Lewandowski K, Szymańska E et al. Skin and gastrointestinal symptoms in COVID-19. Gastroenterology Rev. 2020; 15(4): 301-8.
7. Blackett JW, Li J, Jodorovsky D et al. Prevalence and risk factors for gastrointestinal symptoms after recovery from COVID-19. Neurogastroenterol Motility. 2021. http://doi.org/10.1111/nmo.14251 .
8. Chen B, Kim J, Zhang Y et al. Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J Gastroenterol. 2018; 53(7): 807-18. http://doi.org/10.1007/s00535-018-1476-9.
9. Barbara G, Feinle-Bisset C, Ghoshal U et al. The intestinal microenvironment and functional gastrointestinal disorders. Gastroenterology. 2016; 150: 1305-18.
10. Weaver K, Sherwin L, Wallit B et al. Neuroimaging the brain-gut axis in petientes with irritable bowel syndrome. World J Gastrointest Pharmacol Ther. 2016; 7: 320-33.
11. Van Oudenhove L, Levy R, Crowlel M et al. Biopsychosocial aspects of functional gastrointestinal disorders: how central and environmental processes contribute to the development and expression of functional gastrointestinal disorders. Gastroenterology. 2016; 150: 1355-67.
12. Qin H, Cheng C, Tang X et al. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014; 20: 14126-31.
13. Pietrzak A, Skrzydło-Radomańska B, Mulak A et al. Rekomendacje diagnostyczno-terapeutyczne w zespole jelita nadwrażliwego. Gastroenterol Rev. 2018; 13(4): 2-30.
14. Lacy B, Mearin F, Chang L et al. Bowel disorders. Gastroenterology. 2016; 150: 1393-407.
15. Aasbrenn M, Lydersen S, Farup P. A conservative weight loss intervention relieves bowel symptoms in morbidly obese subjects with irritable bowel syndrome: a prospective cohort study. J Obes. 2018; 18: 3732-753.
16. Laird K, Tanner-Smith E, Russell A et al. Comparative efficacy of psychological therapies for irritable bowel syndrome: a systematic review and meta-analysis. Clin Psychol Rev. 2017; 51: 142-52.
17. Black Ch, Staudacher HM, Ford AC. Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analyzis. Gut. 2021; 0: 1-10. http://doi.org/10.1136/gutjnl-2021-325214.
18. Hou X, Chen S, Zhang Y et al. Quality of life in patients with irritable bowel syndrome assessed using IBS-QoL measure after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide: results of an international prospective observational cohort study in Poland, Egypt, Mexico and China. Clin Drug Investig. 2014; 34(11): 783-93.
19. Kruis W, Weinzierl M, Schlusser P et al. Comparison of therapeutic effects of wheat brain, mebeverine and placebo in patients with the irritable bowel syndrome. Digestion. 1986; 34: 196-201.
20. Vahedi H, Merat S, Momtahen S et al. Clnical trial: the effect of amitriptyline in patients with diarrhea-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2008; 27: 678-84.
21. Tack J, Broekaert D, Fischler B et al. A controlled crossover study of the selective serotonin reuptake inhibitors citalopram in irritable bowel syndrome. Gut. 2006; 55: 1095-103.
22. Talley NJ, Kellow JE, Boyce P et al. Antidepressant therapy (imipramine and citalopram) for irritable bowel syndrome: a double-blind, randomized, placebo-controlled trial. Dig Dis Sci. 2008; 53; 108-15.
23. Pimentel M, Lembo A, Chey W et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011; 363: 22-32.
24. Lembo A, Pimentel M, Rao S et al. Repeat treatment with rifaximin is safe and effective in patients with diarhhea-predominant irritable bowel syndrome. Gastroenterology. 2016; 151: 1113-21.
25. Begtrup LM, de Muckadell OB, Kjedsen J et al. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome – a randomized, double-blind, placebo controlled trial. Scand J Gastroenterol. 2013; 48: 1127-35.
26. Efskind PS, Bernklev T, Vatn MH. A double-blind placebo-controlled trial with loperamide in irritable bowel syndrome. Scand J Gastroenterol. 1996; 31: 463-8.
27. Award RA, Camacho S. A randomized double-blind placebo-controlled trial of polyethylene glycol effects on fasting and postprandial rectal sensitivity and symptoms in hypersensitive constipation-predominant irritable bowel syndrome. Colorectal Dis. 2010; 12: 1131-8.
28. Lam C, Tan W, Yu J et al. A mechanistic multicentre, parallel group, randomized placebo-controlled trial of mesalazine for the treatment of IBS with diarrhea (IBS-D). Gut. 2016; 65: 91-9.
29. Sperber AD, Dumitrascu D, Fukudo S et al. The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. Gut. 2017; 66(6): 1075-82.
30. Skrzydło-Radomańska B. Zespół jelita drażliwego. Med Prakt. 2020; 4: 134-8.
31. Bueno-Notivol J, Gracia-García P, Olaya B et al. Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. Int J Clin Health Psychol. 2021; 21(1): 100196. http://doi.org/10.1016/j.ijchp.2020.07.007.
32. Hossain MM, Rahman M, Trisha NF et al. Prevalence of anxiety and depression in South Asia during COVID-19: a systematic review and meta-analysis. Heliyon. 2021; 7(4): e06677.
33. Gilbody JS, Fletcher CP, Hughes IW et al. Comparison of two different formulations of mebeverine hydrochloride in irritable bowel syndrome. Int J Clin Pract. 2000; 54: 461-4.