Синдром раздраженного кишечника (СРК) представляет собой функциональное расстройство пищеварительного тракта и встречается часто: по разным оценкам от 7–10 до 15–20%. В статье рассматриваются вопросы диагностики СРК и патофизиологические механизмы развития болезни. Особое внимание уделено терапии, поскольку СРК представляет собой сложное заболевание, затрагивающее разные структуры организма, и в данном случае необходим многоцелевой и многокомпонентный подход.
Irritable bowel syndrome (IBS) is a functional disorder of the digestive tract and is common: according to different estimates between 7–10 and 15–20%. The article discusses the diagnosis of IBS and pathophysiological mechanisms in disease development. Special attention is paid to therapy due to IBS is a complex disorder affecting different parts and structures of the body, and in this case it requires multitargeted and multiagent approach.
1. El-Baba MF. Pediatric irritable bowel syndrome. Medscape Reference Web site. http://emedicine.medscape.com/article/930844-overview. Accessed February 2, 2012.
2. Lehrer JK. Irritable bowel syndrome. Medscape Reference Web site. http://emedicine.medscape.com/article/180389-overview. Updated January 13, 2012. Accessed February 9, 2012.
3. Talley NJ. Irritable bowel syndrome. Intern Med J 2006; 36 (11): 724–8.
4. Polmear A. Irritable bowel syndrome. In: Polmear A, ed. Evidence-Based Diagnosis in Primary Care. Edinburgh, Scotland: Elsevier, 2008: 424–8.
5. Hungin AP, Whorwell PJ, Tack J, Mearin F. The prevalence, patterns and impact of irritable bowel syndrome: an international survey of 40,000 subjects. Aliment Pharmacol Ther 2003; 17 (5): 643–50.
6. Maxton DG, Morris J, Whorwell PJ. More accurate diagnosis of irritable bowel syndrome by the use of “non-colonic” symptomatology. Gut 1991; 32 (7): 784–6.
7. Riedl A, Schmidtmann M, Stengel A et al. Somatic comorbidities of irritable bowel syndrome: a systematic analysis. J Psychosom Res 2008; 64 (6): 573–82.
8. Yunus MB. The prevalence of fibromyalgia in other chronic pain conditions. Pain Res Treat 2012; 2012: 584–73.
9. Nickel JC, Tripp DA, Pontari M et al. Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. J Urol 2010; 184 (4): 1358–63.
10. Gasiorowska A, Poh CH, Fass R. Gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS): is it one disease or an overlap of two disorders? Dig Dis Sci 2009; 54 (9): 1829–34.
11. Ford AC, Marwaha A, Lim A, Moayyedi P. Systematic review and meta-analysis of the prevalence of irritable bowel syndrome in individuals with dyspepsia. Clin Gastroenterol Hepatol 2010; 8 (5): 401–9.
12. Arch Intern Med.
13. Cole JA, Rothman KJ, Cabral HJ et al. Migraine, fibromyalgia and depression among people with IBS: a prevalence study. BMC Gastroenterol 2006; 6: 26.
14. Brandt LJ, Chey WD, Foxx-Orenstein AE et al; American College of Gastroenterology Task Force on Irritable Bowel Syndrome. An evidence-based systematic review on the management of irritable bowel syndrome. Am J Gastroenterology 2009; 104 (Suppl. 1): S1–S35.
15. Adeyemo MA, Spiegel BMR, Chang L. Meta-analysis: do irritable bowel symptoms vary between men and women? Aliment Pharmacol Ther 2010; 32 (6): 738–55.
16. Agrawal A, Khan MH, Whorwell PJ. Irritable bowel syndrome in the elderly: an overlooked problem? Dig Liver Dis 2009; 41 (10): 721–4.
17. Suares NC, Ford AC. Diagnosis and treatment of irritable bowel syndrome. Discov Med 2011; 11 (60): 425–33.
18. Yoon SL, Grundmann O, Koepp L, Farrell L. Management of irritablebowelsyndrome (IBS) in adults: conventional and complementary/alternativeapproaches. Altern Med Rev 2011; 16 (2): 134–51.
19. Jellema P, van der Windt DA, Schellevis FG, van der Horst HE. Systematic review: accuracy of symptom-basedcriteria for diagnosis of irritable bowel syndrome in primary care. Aliment Pharmacol Ther 2009; 30 (7): 695–706.
20. Yao X, Yang YS, Cui LH et al. Subtypes of irritable bowel syndrome on Rome III criteria: a multi-center study [published online ahead of print September 19, 2011]. J Gastroenterol Hepatol. DOI:10.1111/j.1440-1746.2011.06930.x.
21. Engsbro AL, Simren M, Bytzer P. Short-term stability of subtypes in irritable bowel syndrome. Aliment Pharmacol Ther 2012; 35 (3): 350–9.
22. Paré P, Gray J, Lam S et al. Health-related quality of life, work productivity, and health care resource utilization of subjects with irritable bowel syndrome: baseline results from LOGIC (Longitudinal Outcomes Study of Gastrointestinal Symptoms in Canada), a naturalistic study. Clin Ther 2006; 28 (10): 1726–35.
23. Guilera M, Balboa A, Mearin F. Bowel habit subtypes and temporal patterns in irritable bowel syndrome: systematic review. Am J Gastroenterol 2005; 100 (5): 1174–84.
24. Gasbarrini A, Lauritano EC, Garcovich M et al. New insights into the pathophysiology of IBS: intestinal microflora, gas production and gut motility. Eur Rev Med Pharmacol Sci 2008; 12 (Suppl. 1): 111–7.
25. Sainsbury A, Ford AC. Treatment of irritable bowel syndrome: beyond fiber and antispasmodic agents. Ther Adv Gastroenterol 2011; 4 (2): 115–27.
26. Storr M, Allescher HD. Irritable bowel syndrome: a dysfunction of the endocannabinoid system? Gastroenterology 2012; 142 (2): 406–8.
27. Storr MA, Yüce B, Andrews CN, Sharkey KA. The role of the endocannabanoid system in the pathophysiology and treatment of irritable bowel syndrome. Neurogastroenterol Motil 2008; 20 (8): 857–68.
28. Gerson MJ, Gerson CD. The importance of relationships in patients with irritable bowel syndrome: a review. Gastroenterol Res Pract 2012; 2012: 157–340.
29. Longstreth GF, Thompson WG, Chey WD et al. Functional bowel disorders. Gastroenterology. 2006; 130 (5): 1480–91.
30. Tighe MP, Cummings JR, Afzal NA. Nutrition and inflammatory bowel disease: primary or adjuvant therapy. Curr Opin Clin Nutr Metab Care 2011; 14 (5): 491–96.
31. Eswaran S, Tack J, Chey WD. Food: the forgotten factor in the irritable bowel syndrome. Gastroenterol Clin North Am 2011; 40 (1): 141–62.
32. Morcos A, Dinan T, Quigley EM. Irritable bowel syndrome: role of food in pathogenesis and management. J Dig Dis 2009; 10 (4): 237–46.
33. Fernandez-Banares F, Esteve M, Viver JM. Fructose-sorbitol malabsorption. Curr Gastroenterol Rep 2009; 11 (5): 368–74.
34. Gibson PR, Newnham E, Barrett JS et al. Review article: fructose malabsorption and the bigger picture. Aliment Pharmacol Ther 2007; 25 (4): 349–63.
35. Clarke G, Fitzgerald P, Hennessy AA et al. Marked elevations in pro-inflammatory polyunsaturated fatty acid metabolites in females with irritable bowel syndrome. J Lipid Res 2010; 51 (5): 1186–92.
36. Fujiwara Y, Kubo M, Kohata Y et al. Cigarette smoking and its association with overlapping gastroesophageal reflux disease, functional dyspepsia, or irritable bowel syndrome. Intern Med 2011; 50 (21): 2443–7.
37. Masand PS, Sousou AJ, Gupta S, Kaplan DS. Irritable bowel syndrome (IBS) and alcohol abuse or dependence. Am J Drug Alcohol Abuse 1998; 24 (3): 513–21.
38. Bellini M, Gemignani A, Gambaccini D et al. Evaluation of latent links between irritable bowel syndrome and sleep quality. World J Gastroenterol 2011; 17 (46): 5089–96.
39. Dinan TG, Cryan J, Shanahan F et al. IBS: an epigenetic perspective. Nat Rev Gastroenterol Hepatol 2010; 7 (8): 465–71.
40. Keohane J, O'Mahony C, O'Mahony L et al. Irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease: a real association or reflection of occult inflammation? Am J Gastroenterol 2010; 105 (8): 1789–94.
41. Ford AC, Talley NJ. Mucosal inflammation as a potential etiological factor in irritable bowel syndrome: a systematic review. J Gastroenterol 2011; 46 (4): 421–31.
42. Vivinus-Nebot M, Dainese R, Anty R et al. Combination of allergic factors can worsen diarrheic irritable bowel syndrome: role of barrier defects and mast cells. Am J Gastroenterol 2012; 107 (1): 75–81.
43. Thabane M, Marshall JK. Post-infectious irritable bowel syndrome. World J Gastroenterol 2009; 15 (29): 3591–6.
44. Lin HC, Pimentel M. Bacterial concepts in irritable bowel syndrome. Rev Gastroenterol Disord. 2005; 5 (Suppl. 3): S3–S9.
45. Olivo-Diaz A, Romero-Valdovinos M, Gudiño-Ramirez A et al. Findings related to IL-8 and IL-10 gene polymorphisms in a Mexican patient population with irritable bowel syndrome infected with Blastocystis [published online ahead of print January 28, 2012]. Parasitol Res 2012; 111 (1): 487–91. DOI:10.1007/s00436-012-2830-0
46. Goettsch WG, van den Boom G, Breekveldt-Postma NS et al. Treatment patterns and health care costs of mebeverine-treated IBS patients: a case-control study. Pharmacoepidemiol Drug Saf 2004; 13 (11): 803–10.
47. Lembo A. Irritable bowel syndrome medications side effects survey. J Clin Gastroenterol 2004; 38 (9): 776–81.
48. Tack J, Fried M, Houghton LA et al. Systematic review: the efficacy of treatments for irritable bowel syndrome – a European perspective. Aliment Pharmacol Ther 2006; 24 (2): 183–205.
49. Whorwell PJ. Irritable bowel syndrome. Altern Ther Health Med 2011; 17 (2) (Suppl.): S4–S6.
________________________________________________
1. El-Baba MF. Pediatric irritable bowel syndrome. Medscape Reference Web site. http://emedicine.medscape.com/article/930844-overview. Accessed February 2, 2012.
2. Lehrer JK. Irritable bowel syndrome. Medscape Reference Web site. http://emedicine.medscape.com/article/180389-overview. Updated January 13, 2012. Accessed February 9, 2012.
3. Talley NJ. Irritable bowel syndrome. Intern Med J 2006; 36 (11): 724–8.
4. Polmear A. Irritable bowel syndrome. In: Polmear A, ed. Evidence-Based Diagnosis in Primary Care. Edinburgh, Scotland: Elsevier, 2008: 424–8.
5. Hungin AP, Whorwell PJ, Tack J, Mearin F. The prevalence, patterns and impact of irritable bowel syndrome: an international survey of 40,000 subjects. Aliment Pharmacol Ther 2003; 17 (5): 643–50.
6. Maxton DG, Morris J, Whorwell PJ. More accurate diagnosis of irritable bowel syndrome by the use of “non-colonic” symptomatology. Gut 1991; 32 (7): 784–6.
7. Riedl A, Schmidtmann M, Stengel A et al. Somatic comorbidities of irritable bowel syndrome: a systematic analysis. J Psychosom Res 2008; 64 (6): 573–82.
8. Yunus MB. The prevalence of fibromyalgia in other chronic pain conditions. Pain Res Treat 2012; 2012: 584–73.
9. Nickel JC, Tripp DA, Pontari M et al. Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. J Urol 2010; 184 (4): 1358–63.
10. Gasiorowska A, Poh CH, Fass R. Gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS): is it one disease or an overlap of two disorders? Dig Dis Sci 2009; 54 (9): 1829–34.
11. Ford AC, Marwaha A, Lim A, Moayyedi P. Systematic review and meta-analysis of the prevalence of irritable bowel syndrome in individuals with dyspepsia. Clin Gastroenterol Hepatol 2010; 8 (5): 401–9.
12. Arch Intern Med.
13. Cole JA, Rothman KJ, Cabral HJ et al. Migraine, fibromyalgia and depression among people with IBS: a prevalence study. BMC Gastroenterol 2006; 6: 26.
14. Brandt LJ, Chey WD, Foxx-Orenstein AE et al; American College of Gastroenterology Task Force on Irritable Bowel Syndrome. An evidence-based systematic review on the management of irritable bowel syndrome. Am J Gastroenterology 2009; 104 (Suppl. 1): S1–S35.
15. Adeyemo MA, Spiegel BMR, Chang L. Meta-analysis: do irritable bowel symptoms vary between men and women? Aliment Pharmacol Ther 2010; 32 (6): 738–55.
16. Agrawal A, Khan MH, Whorwell PJ. Irritable bowel syndrome in the elderly: an overlooked problem? Dig Liver Dis 2009; 41 (10): 721–4.
17. Suares NC, Ford AC. Diagnosis and treatment of irritable bowel syndrome. Discov Med 2011; 11 (60): 425–33.
18. Yoon SL, Grundmann O, Koepp L, Farrell L. Management of irritablebowelsyndrome (IBS) in adults: conventional and complementary/alternativeapproaches. Altern Med Rev 2011; 16 (2): 134–51.
19. Jellema P, van der Windt DA, Schellevis FG, van der Horst HE. Systematic review: accuracy of symptom-basedcriteria for diagnosis of irritable bowel syndrome in primary care. Aliment Pharmacol Ther 2009; 30 (7): 695–706.
20. Yao X, Yang YS, Cui LH et al. Subtypes of irritable bowel syndrome on Rome III criteria: a multi-center study [published online ahead of print September 19, 2011]. J Gastroenterol Hepatol. DOI:10.1111/j.1440-1746.2011.06930.x.
21. Engsbro AL, Simren M, Bytzer P. Short-term stability of subtypes in irritable bowel syndrome. Aliment Pharmacol Ther 2012; 35 (3): 350–9.
22. Paré P, Gray J, Lam S et al. Health-related quality of life, work productivity, and health care resource utilization of subjects with irritable bowel syndrome: baseline results from LOGIC (Longitudinal Outcomes Study of Gastrointestinal Symptoms in Canada), a naturalistic study. Clin Ther 2006; 28 (10): 1726–35.
23. Guilera M, Balboa A, Mearin F. Bowel habit subtypes and temporal patterns in irritable bowel syndrome: systematic review. Am J Gastroenterol 2005; 100 (5): 1174–84.
24. Gasbarrini A, Lauritano EC, Garcovich M et al. New insights into the pathophysiology of IBS: intestinal microflora, gas production and gut motility. Eur Rev Med Pharmacol Sci 2008; 12 (Suppl. 1): 111–7.
25. Sainsbury A, Ford AC. Treatment of irritable bowel syndrome: beyond fiber and antispasmodic agents. Ther Adv Gastroenterol 2011; 4 (2): 115–27.
26. Storr M, Allescher HD. Irritable bowel syndrome: a dysfunction of the endocannabinoid system? Gastroenterology 2012; 142 (2): 406–8.
27. Storr MA, Yüce B, Andrews CN, Sharkey KA. The role of the endocannabanoid system in the pathophysiology and treatment of irritable bowel syndrome. Neurogastroenterol Motil 2008; 20 (8): 857–68.
28. Gerson MJ, Gerson CD. The importance of relationships in patients with irritable bowel syndrome: a review. Gastroenterol Res Pract 2012; 2012: 157–340.
29. Longstreth GF, Thompson WG, Chey WD et al. Functional bowel disorders. Gastroenterology. 2006; 130 (5): 1480–91.
30. Tighe MP, Cummings JR, Afzal NA. Nutrition and inflammatory bowel disease: primary or adjuvant therapy. Curr Opin Clin Nutr Metab Care 2011; 14 (5): 491–96.
31. Eswaran S, Tack J, Chey WD. Food: the forgotten factor in the irritable bowel syndrome. Gastroenterol Clin North Am 2011; 40 (1): 141–62.
32. Morcos A, Dinan T, Quigley EM. Irritable bowel syndrome: role of food in pathogenesis and management. J Dig Dis 2009; 10 (4): 237–46.
33. Fernandez-Banares F, Esteve M, Viver JM. Fructose-sorbitol malabsorption. Curr Gastroenterol Rep 2009; 11 (5): 368–74.
34. Gibson PR, Newnham E, Barrett JS et al. Review article: fructose malabsorption and the bigger picture. Aliment Pharmacol Ther 2007; 25 (4): 349–63.
35. Clarke G, Fitzgerald P, Hennessy AA et al. Marked elevations in pro-inflammatory polyunsaturated fatty acid metabolites in females with irritable bowel syndrome. J Lipid Res 2010; 51 (5): 1186–92.
36. Fujiwara Y, Kubo M, Kohata Y et al. Cigarette smoking and its association with overlapping gastroesophageal reflux disease, functional dyspepsia, or irritable bowel syndrome. Intern Med 2011; 50 (21): 2443–7.
37. Masand PS, Sousou AJ, Gupta S, Kaplan DS. Irritable bowel syndrome (IBS) and alcohol abuse or dependence. Am J Drug Alcohol Abuse 1998; 24 (3): 513–21.
38. Bellini M, Gemignani A, Gambaccini D et al. Evaluation of latent links between irritable bowel syndrome and sleep quality. World J Gastroenterol 2011; 17 (46): 5089–96.
39. Dinan TG, Cryan J, Shanahan F et al. IBS: an epigenetic perspective. Nat Rev Gastroenterol Hepatol 2010; 7 (8): 465–71.
40. Keohane J, O'Mahony C, O'Mahony L et al. Irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease: a real association or reflection of occult inflammation? Am J Gastroenterol 2010; 105 (8): 1789–94.
41. Ford AC, Talley NJ. Mucosal inflammation as a potential etiological factor in irritable bowel syndrome: a systematic review. J Gastroenterol 2011; 46 (4): 421–31.
42. Vivinus-Nebot M, Dainese R, Anty R et al. Combination of allergic factors can worsen diarrheic irritable bowel syndrome: role of barrier defects and mast cells. Am J Gastroenterol 2012; 107 (1): 75–81.
43. Thabane M, Marshall JK. Post-infectious irritable bowel syndrome. World J Gastroenterol 2009; 15 (29): 3591–6.
44. Lin HC, Pimentel M. Bacterial concepts in irritable bowel syndrome. Rev Gastroenterol Disord. 2005; 5 (Suppl. 3): S3–S9.
45. Olivo-Diaz A, Romero-Valdovinos M, Gudiño-Ramirez A et al. Findings related to IL-8 and IL-10 gene polymorphisms in a Mexican patient population with irritable bowel syndrome infected with Blastocystis [published online ahead of print January 28, 2012]. Parasitol Res 2012; 111 (1): 487–91. DOI:10.1007/s00436-012-2830-0
46. Goettsch WG, van den Boom G, Breekveldt-Postma NS et al. Treatment patterns and health care costs of mebeverine-treated IBS patients: a case-control study. Pharmacoepidemiol Drug Saf 2004; 13 (11): 803–10.
47. Lembo A. Irritable bowel syndrome medications side effects survey. J Clin Gastroenterol 2004; 38 (9): 776–81.
48. Tack J, Fried M, Houghton LA et al. Systematic review: the efficacy of treatments for irritable bowel syndrome – a European perspective. Aliment Pharmacol Ther 2006; 24 (2): 183–205.
49. Whorwell PJ. Irritable bowel syndrome. Altern Ther Health Med 2011; 17 (2) (Suppl.): S4–S6.