肠易激综合征诊治新观念.ppt

* Physicians have been aware of the symptoms of irritable bowel syndrome (IBS) for well over a century. The first reports in medical journals of patients with functional abdominal symptoms appeared in the early 19th century. In 1849, Cumming aptly described IBS when he stated: “The bowels are at one time constipated, at another lax, in the same person. How the disease has two such different symptoms, I do not profess to explain. . . .”1 Throughout the 19th and into the 20th century, some of the other terms used to describe IBS were neurogenic mucous colitis,2 spastic colon,3 and irritable colon syndrome.4 However, it wasn’t until just over 30 years ago that the term irritable bowel syndrome was coined. In 1966, DeLor referred to the irritable bowel syndrome, defining it as a functional enteropathy, characterized by one or a combination of symptoms, including abdominal pain, diarrhea, constipation, dyschezia, and passage of mucus in the stool.5 References:1. Cumming W. Electro-galvanism in a peculiar affection of the mucous membrane of the bowels. Lond Med Gazette. 1849;NS9:969-973. 2. Bockus HL, Bank J, Wilkinson SA. Neurogenic mucous colitis. Am J Med Sci. 1928;176:813-829. 3. Ryle JA. Chronic spasmodic affections of the colon and the diseases which they  simulate. Lancet. December 1928;215:1115-1119. 4. Chaudhary NA, Truelove SC. The irritable colon syndrome. Q J Med. July  1962;31:307-322. 5. DeLor CJ. The irritable bowel syndrome. Am J Gastroenterol. May 1967;47:427-434. * Diagnostic approaches continue to change. In the 1950s, physicians believed increased gut motility was the underlying cause of IBS. In the 1970s, specific motility markers were used to define IBS, and in the 1980s, diagnostic criteria were developed to help doctors make more positive diagnoses. The Manning criteria, introduced in 1978, identified a number of key features that were predictive of IBS. These criteria were further refined by the Rome Committee for use in clinical resea