Division of Gastroenterology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea.
J Neurogastroenterol Motil. 2010 Apr;16(2):120-30. doi: 10.5056/jnm.2010.16.2.120. Epub 2010 Apr 27.
Altered motility remains one of the important pathophysiologic factors in patients with irritable bowel syndrome (IBS) who commonly complain of abdominal pain and stool changes such as diarrhea and constipation. The prevalence of IBS has increased among Asian populations these days. Gastrointestinal (GI) physiology may vary between Asian and Western populations because of differences in diets, socio-cultural backgrounds, and genetic factors. The characteristics and differences of GI dysmotility in Asian IBS patients were reviewed. MEDLINE search work was performed including following terms, 'IBS,' 'motility,' 'transit time,' 'esophageal motility,' 'gastric motility,' 'small intestinal motility,' 'colonic motility,' 'anorectal function,' and 'gallbladder motility' and over 100 articles were categorized under 'esophagus,' 'stomach,' 'small intestine,' 'colon,' 'anorectum,' 'gallbladder,' 'transit,' 'motor pattern,' and 'effect of stressors.' Delayed gastric emptying, slow tansit in constipation predominant IBS patients, rapid transit in diarrhea predominant IBS patients, accelerated motility responses to various stressors such as meals, mental stress, or corticotrophin releasing hormones, and altered rectal compliance and altered rectal accomodation were reported in many Asian studies regarding IBS. Many conflicting results were found among these studies and there are still controversies to conclude these as unique features of Asian IBS patients. Multinational and multicenter studies are needed to be performed vigorously in order to elaborate characteristics as well as differences of altered motililty in Asian patients with IBS.
动力改变仍然是肠易激综合征(IBS)患者的重要病理生理因素之一,这些患者常主诉腹痛和粪便改变,如腹泻和便秘。如今,亚洲人群中 IBS 的患病率有所增加。由于饮食、社会文化背景和遗传因素的差异,亚洲人和西方人之间的胃肠道(GI)生理学可能有所不同。本文综述了亚洲 IBS 患者的 GI 动力障碍的特征和差异。进行了 MEDLINE 检索工作,包括以下术语:“IBS”、“动力”、“传输时间”、“食管动力”、“胃动力”、“小肠动力”、“结肠动力”、“肛门直肠功能”和“胆囊动力”,并将 100 多篇文章归类为“食管”、“胃”、“小肠”、“结肠”、“肛门直肠”、“胆囊”、“传输”、“运动模式”和“应激源的影响”。在许多关于 IBS 的亚洲研究中,报道了胃排空延迟、便秘型 IBS 患者传输缓慢、腹泻型 IBS 患者传输加快、对各种应激源(如进餐、精神压力或促肾上腺皮质激素释放激素)的动力反应加速以及直肠顺应性改变和直肠顺应性改变。这些研究中存在许多相互矛盾的结果,对于这些结果是否可作为亚洲 IBS 患者的独特特征仍存在争议。需要大力开展跨国和多中心研究,以阐明亚洲 IBS 患者动力改变的特征和差异。