_bowel syndrome mechanisms and dietary 肠易激综合征的机制和膳食课件

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1、NutritionalManagementofIrritableBowelSyndromeJaniceJoneja,Ph.D.,RDIrritableBowelSyndromeIrritablebowelsyndrome(IBS)tendstobeanumbrellatermforavarietyofminorboweldisturbancesofunknownoriginSometimescalled:“irritablecolon”“spasticcolon”2SymptomsofIBSSymptomsinclu

2、de:ChangeinbowelhabitoftenalternatingconstipationanddiarrheaAbdominalbloatinganddistensionSometimesabdominalpain,frequentlyrelievedbydefecationFeelingofincompletedefecation3IBSCharacteristicsThereisusuallynosignofstructuraldamagetothewalloftheintestine(frequentl

3、yindicatedbybloodinthestool)WeightlossornighttimefeverarenotexperiencedAdiagnosisofirritablebowelsyndromeismadewhenallorganicdiseasehasbeenruledoutbyappropriatemedicaltestsTheManningCriteriaortheRomeIIquestionnairesareoftenusedfordiagnosis4InitialTriggersofIBSIn

4、fectioninthedigestivetract:VirusesBacteriaParasites(amoeba;intestinalworms)PathologyinthedigestivetractInflammatoryboweldiseaseCoeliacdiseaseSurgicalproceduresinthedigestivetract5TriggersofIBS(continued)Stress:StresshormonesarereleasedNeuropeptidesmaytriggerther

5、eleaseofinflammatorychemicalsHormonefluctuations:MenstrualcyclePregnancyThyroid6TriggersofIBS(continued)Changeintypesofmicro-organismsinthelargeintestinedueto:OralantibioticsOtheroralmedicationsChangeinsubstrate(ietypeoffoodpassingintothebowel)Alterationinmicrob

6、ialfloraresultsin:Differentproductsresultingfromtheactionofmicro-organismsonundigestedfoodmaterial:GasesOrganicacidsOthers7MechanismsResponsibleforSymptomsKeyfactorsinIBSresultinginsymptomsinclude:InflammationResultingfromreleaseofinflammatorymediatorsIncreaseds

7、ensitivitytopainNeuropeptides(tachykinins)generatedbythecentralnervoussysteminteractwithneurokininreceptorsonthespinalcordMayalsoresultfromaresponsetoinflammatorymediators(e.g.histamine)8MechanismsResponsibleforSymptoms(continued)MotilitydysfunctionResultingfrom

8、changesinautonomicnervoussystemsignalsResultingfromproductsofmicrobialfermentationFermentationOfundigestedfoodinthelargebowelAsaconsequenceofabnormalmotilityAsaconseq