_Bowel Syndrome Mechanisms and Dietary 肠易激综合征的机制和膳食课件.ppt

Janice M. Joneja, Ph.D., RD. 2003 Nutritional Management ofIrritable Bowel Syndrome Janice Joneja, Ph.D., RD Irritable Bowel Syndrome Irritable bowel syndrome (IBS) tends to be an umbrella term for a variety of minor bowel disturbances of unknown origin Sometimes called: “irritable colon” “spastic colon” Symptoms of IBS Symptoms include: Change in bowel habit often alternating constipation and diarrhea Abdominal bloating and distension Sometimes abdominal pain, frequently relieved by defecation Feeling of incomplete defecation IBS Characteristics There is usually no sign of structural damage to the wall of the intestine (frequently indicated by blood in the stool) Weight loss or nighttime fever are not experienced A diagnosis of irritable bowel syndrome is made when all organic disease has been ruled out by appropriate medical tests The Manning Criteria or the Rome II questionnaires are often used for diagnosis Initial Triggers of IBS Infection in the digestive tract: Viruses Bacteria Parasites (amoeba; intestinal worms) Pathology in the digestive tract Inflammatory bowel disease Coeliac disease Surgical procedures in the digestive tract Triggers of IBS (continued) Stress: Stress hormones are released Neuropeptides may trigger the release of inflammatory chemicals Hormone fluctuations: Menstrual cycle Pregnancy Thyroid Triggers of IBS (continued) Change in types of micro-organisms in the large intestine due to: Oral antibiotics Other oral medications Change in substrate (ie type of food passing into the bowel) Alteration in microbial flora results in: Different products resulting from the action of micro-organisms on undigested food material: Gases Organic acids Others Mechanisms Responsible for Symptoms Key factors in IBS resulting in symptoms include: Inflammation Resulting from release of inflammatory mediators Increased sensitivity to pain Neuropeptides (tachykinins) generated by the central nervous system interact with neurokinin