amygdala and dorsomedial frontal cortex 悔婚拒返彩礼被拘

Medicine Traditionally, IBS is conceptualized as a condition of visceral hypersensitivity and gastrointestinal motor disturbances. The gastrointestinal motor disturbances identified do not easily explain mixed or alternating IBS. Some have suggested that these abnormalities are secondary to psychological disturbances rather than being of primary relevance. But, not all patients with IBS have significant psychological overlay and referral bias may partly account for the psychological associations. There is now convincing evidence that IBS can arise after bacterial gastroenteritis in up to a quarter of cases. There is also accumulating evidence that a subgroup of patients labelled as IBS have subtle inflammatory bowel disease, although the exact prevalence of these findings in IBS overall remains unclear. And there is also a change in peripheral cytokine profiles in IBS reminiscent of those seen in inflammatory bowel disease. Whether inflammation can alter mucosal control of motility is an area of active research interest. Serotonin, present largely in the enterochromaffin cells in the gut, is a major regulator of the peristaltic reflex and sensory relays in the gut. Two lines of evidence support the view that serotonin regulation is abnormal in IBS. The release of serotonin in plasma appears to be reduced in those with constipation-predominant IBS and increased in diarrhoea. In a seminal paper, rectal biopsy specimens were assessed in patients with IBS, ulcerative colitis and controls. A defect in serotonin signalling was noted in both IBS and ulcerative colitis, with a reduction in normal mucosal serotonin and serotonin transporter immunoreactivity in both diseases. This implies that there may be a real molecular defect in IBS, which conceivably is acquired possibly after infection. In the presence of dysregulated gastrointestinal motor function, it is conceivable that stasis promotes small intestinal bacterial overgrowth to occur, inducing fermentation and leading to production of excess gas. The gas in turn may be trapped and induce some symptoms of IBS, including discomfort and bloating. There is some direct and indirect evidence in support of this hypothesis, which has management implications, although further work is required to confirm the observations. Psychosocial factors do appear to be important in IBS, although whether these factors directly alter gastrointestinal function remains uncertain. It is possible that gastrointestinal dysfunction modulates central processes too. For example, there is good evidence now that abuse in childhood or adulthood is associated with IBS, although whether it is of aetiological importance remains in dispute. Anxiety and depression are also common in IBS. There are differences in brain responses in patients with IBS documented. For example, measures of regional cerebral blood flow during rectal distention have shown that IBS patients have greater activation of the anterior cingulate cortex, amygdala and dorsomedial frontal cortex, in contrast to patients with ulcerative colitis and controls. It has been postulated that the brains of people without IBS are better able to activate endogenous pain inhibition areas. Dietary therapy for IBS is of limited value. There is now reasonable evidence that constipation will improve with an increased fibre intake, but pain and diarrhoea probably do not do any better on fibre than with placebo. However, anecdotally some with diarrhoea will have a firming up of their stools with the introduction of fibre. Fibre supplements may be better tolerated but need to be started at a low dose and built up slowly because of the increase in bloating that often occurs with their use. Antispasmodic agents have been shown in clinical trials to be superior to placebo in terms of improvement of abdominal pain; but the quality of the trials is not high. Plant medicine has analgesic and antispasmodic effect against IBS. Plant medicine strengthens immune parameters of IBS patients. Medicinal plant extracts exhibiting a calming analgesic effect, with antispasmolytic properties on the smooth muscle of the bowel and gut are what make plant medicine so successful as an irritable bowel syndrome treatment formula. Application of plant medicine for IBS reduces colonic pressure and prevents foaming, all of which helps reduce colic pain. To learn more, please go to . About the Author: 相关的主题文章: