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Gastrointestinal motility disorders in inflammatory bowel diseases

机译:炎症性肠病中的胃肠动力异常

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The relationship between motility and inflammatory gastrointestinal disorders is at the same time complex and intriguing since these conditions might share some genetic, environmental, immunological and microbial predisposing factors. In addition, significant symptom overlapping may occur, muddling the waters within the clinical context. Although on one hand this represents a challenge for the clinician for a potential under- or over-treatment and diagnostic delay, on the other hand it possibly represents an opportunity for the researcher to better disclose the intimate relationship between chronic (often low-grade) inflammation, motor disorders and deranged sensory function. The best example is probably represented by Crohn’s disease and ulcerative colitis. In fact, a number of gastrointestinal motor disorders have been described in association with these diseases, disorders which span from the esophagus to the anorectum, and which will be extensively covered in this review. It is conceivable that at least part of this derangement is strictly related to inflammatory cytokine trafficking and neuromuscular changes; however, given the high prevalence of functional gastrointestinal disorders in the general population, this overlap might also be serendipitous. However, it is worth noting that literature data on this topic are relatively scarce, sometimes quite outdated, and mostly focused on the interplay between irritable bowel syndrome and inflammatory bowel disease. Nevertheless, both researchers and clinicians must be aware that symptoms related to gastrointestinal motility disorders may be highly prevalent in both active and inactive inflammatory bowel disease, correlate with greater psychological comorbidity and poorer quality of life, and may negatively influence the therapeutic approaches.
机译:动力与炎症性胃肠道疾病之间的关系同时也是复杂而有趣的,因为这些疾病可能共享某些遗传,环境,免疫学和微生物易感性因素。此外,可能会出现明显的症状重叠,使临床环境中的水混乱。尽管一方面,这给临床医生带来了潜在的治疗不足或过度治疗以及诊断延迟的挑战,但另一方面,这可能为研究人员提供了一个机会,可以更好地揭示慢性病(通常是低等)之间的亲密关系。炎症,运动障碍和感觉功能异常。最好的例子可能是克罗恩病和溃疡性结肠炎。实际上,已经描述了许多与这些疾病有关的胃肠道运动疾病,这些疾病范围从食道到肛门直肠,并将在本综述中广泛涉及。可以想象,这种紊乱的至少一部分与炎症性细胞因子的运输和神经肌肉的变化密切相关。但是,鉴于一般人群中功能性胃肠疾病的患病率很高,这种重叠可能也是偶然的。但是,值得注意的是,有关该主题的文献数据相对较少,有时甚至已经过时,并且主要集中在肠易激综合征和炎症性肠病之间的相互作用。然而,研究人员和临床医生都必须意识到,与胃肠道蠕动障碍有关的症状在活跃和不活跃的炎症性肠病中可能都非常普遍,与更大的心理合并症和较差的生活质量相关,并且可能对治疗方法产生负面影响。

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