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過敏性腸症候群(IBS)の治療:第3段階

出典
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1: 日本消化器病学会編:機能性消化管疾患診療ガイドライン2020―過敏性腸症候群(IBS)改訂第2版, p.xxii, 2020, 南江堂 より許諾を得て転載

過敏性腸症候群(IBS)のRome IV診断基準

他疾患が否定されれば、脳腸相関病(disorders of gut-brain interaction:DGBI)であり、Rome IV基準に基づいてIBSを診断する。IBSは、Bristol便形状尺度([ID0603])に基づいて4型に便宜的に分類する([ID0605])。Rome IVのIBS診断基準を満たさなければ、IBS以外のDGBIである。腹痛のない便秘は機能性便秘、腹痛のない下痢は機能性下痢、便通異常のない腹痛は機能性腹痛症候群、便通異常のない腹部膨満感は機能性腹部膨満、いずれでもなければ非特異機能性腸疾患である。Rome IVは2016年に公刊された。
出典
imgimg
1: Bowel Disorders.
著者: Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R.
雑誌名: Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epub 2016 Feb 18.
Abstract/Text: Functional bowel disorders are highly prevalent disorders found worldwide. These disorders have the potential to affect all members of society, regardless of age, gender, race, creed, color or socioeconomic status. Improving our understanding of functional bowel disorders (FBD) is critical as they impose a negative economic impact to the global health care system in addition to reducing quality of life. Research in the basic and clinical sciences during the past decade has produced new information on the epidemiology, etiology, pathophysiology, diagnosis and treatment of FBDs. These important findings created a need to revise the Rome III criteria for FBDs, last published in 2006. This manuscript classifies the FBDs into five distinct categories: irritable bowel syndrome (IBS); functional constipation (FC); functional diarrhea (FDr); functional abdominal bloating/distention (FAB/D); and unspecified FBD (U-FBD). Also included in this article is a new sixth category, opioid induced constipation (OIC) which is distinct from the functional bowel disorders (FBDs). Each disorder will first be defined, followed by sections on epidemiology, rationale for changes from prior criteria, clinical evaluation, physiologic features, psychosocial features and treatment. It is the hope of this committee that this new information will assist both clinicians and researchers in the decade to come.

Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.
Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epu...

過敏性腸症候群(IBS)の分類(Rome IV)

出典
imgimg
1: Bowel Disorders.
著者: Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R.
雑誌名: Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epub 2016 Feb 18.
Abstract/Text: Functional bowel disorders are highly prevalent disorders found worldwide. These disorders have the potential to affect all members of society, regardless of age, gender, race, creed, color or socioeconomic status. Improving our understanding of functional bowel disorders (FBD) is critical as they impose a negative economic impact to the global health care system in addition to reducing quality of life. Research in the basic and clinical sciences during the past decade has produced new information on the epidemiology, etiology, pathophysiology, diagnosis and treatment of FBDs. These important findings created a need to revise the Rome III criteria for FBDs, last published in 2006. This manuscript classifies the FBDs into five distinct categories: irritable bowel syndrome (IBS); functional constipation (FC); functional diarrhea (FDr); functional abdominal bloating/distention (FAB/D); and unspecified FBD (U-FBD). Also included in this article is a new sixth category, opioid induced constipation (OIC) which is distinct from the functional bowel disorders (FBDs). Each disorder will first be defined, followed by sections on epidemiology, rationale for changes from prior criteria, clinical evaluation, physiologic features, psychosocial features and treatment. It is the hope of this committee that this new information will assist both clinicians and researchers in the decade to come.

Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.
Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epu...

Bristol便形状尺度説明図

出典
imgimg
1: Bowel Disorders.
著者: Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R.
雑誌名: Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epub 2016 Feb 18.
Abstract/Text: Functional bowel disorders are highly prevalent disorders found worldwide. These disorders have the potential to affect all members of society, regardless of age, gender, race, creed, color or socioeconomic status. Improving our understanding of functional bowel disorders (FBD) is critical as they impose a negative economic impact to the global health care system in addition to reducing quality of life. Research in the basic and clinical sciences during the past decade has produced new information on the epidemiology, etiology, pathophysiology, diagnosis and treatment of FBDs. These important findings created a need to revise the Rome III criteria for FBDs, last published in 2006. This manuscript classifies the FBDs into five distinct categories: irritable bowel syndrome (IBS); functional constipation (FC); functional diarrhea (FDr); functional abdominal bloating/distention (FAB/D); and unspecified FBD (U-FBD). Also included in this article is a new sixth category, opioid induced constipation (OIC) which is distinct from the functional bowel disorders (FBDs). Each disorder will first be defined, followed by sections on epidemiology, rationale for changes from prior criteria, clinical evaluation, physiologic features, psychosocial features and treatment. It is the hope of this committee that this new information will assist both clinicians and researchers in the decade to come.

Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.
Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epu...

過敏性腸症候群(IBS)の分類(Rome IV)

1. 便秘型IBS(IBS-C):硬便or兎糞状便aが便形状が25%以上、かつ、軟便or水様便bが便形状の25%未満c
2. 下痢型IBS(IBS-D):軟便or水様便bが便形状の25%以上、かつ、硬便or兎糞状便aが便形状の25%未満c
3.混合型IBS(IBS-M):硬便or兎糞状便aが便形状の25%以上、かつ、軟便or水様便bが便形状の25%以上c
4.分類不能型IBS(IBS-U):便形状の異常が不十分であって、IBS-C、IBS-D、IBS-Mのいずれでもない
出典
imgimg
1: Bowel Disorders.
著者: Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R.
雑誌名: Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epub 2016 Feb 18.
Abstract/Text: Functional bowel disorders are highly prevalent disorders found worldwide. These disorders have the potential to affect all members of society, regardless of age, gender, race, creed, color or socioeconomic status. Improving our understanding of functional bowel disorders (FBD) is critical as they impose a negative economic impact to the global health care system in addition to reducing quality of life. Research in the basic and clinical sciences during the past decade has produced new information on the epidemiology, etiology, pathophysiology, diagnosis and treatment of FBDs. These important findings created a need to revise the Rome III criteria for FBDs, last published in 2006. This manuscript classifies the FBDs into five distinct categories: irritable bowel syndrome (IBS); functional constipation (FC); functional diarrhea (FDr); functional abdominal bloating/distention (FAB/D); and unspecified FBD (U-FBD). Also included in this article is a new sixth category, opioid induced constipation (OIC) which is distinct from the functional bowel disorders (FBDs). Each disorder will first be defined, followed by sections on epidemiology, rationale for changes from prior criteria, clinical evaluation, physiologic features, psychosocial features and treatment. It is the hope of this committee that this new information will assist both clinicians and researchers in the decade to come.

Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.
Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epu...

過敏性腸症候群(IBS)に対する薬物療法

出典
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1: 小牧元,久保千春,福土審編.心身症診断治療ガイドライン2006.協和企画,2006;p29.(改変)

過敏性腸症候群(IBS)の診断フローチャート

出典
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1: 日本消化器病学会編:機能性消化管疾患診療ガイドライン2020―過敏性腸症候群(IBS)改訂第2版, p.xvi, 2020, 南江堂 より許諾を得て転載

過敏性腸症候群(IBS)の治療:第1段階

出典
img
1: 日本消化器病学会編:機能性消化管疾患診療ガイドライン2020―過敏性腸症候群(IBS)改訂第2版, p.xx, 2020, 南江堂 より許諾を得て転載

過敏性腸症候群(IBS)の治療:第2段階

出典
img
1: 日本消化器病学会編:機能性消化管疾患診療ガイドライン2020―過敏性腸症候群(IBS)改訂第2版, p.xxi, 2020, 南江堂 より許諾を得て転載

心身症としての過敏性腸症候群(IBS)の診断基準

出典
img
1: 小牧元,久保千春,福土審編.心身症診断治療ガイドライン2006.協和企画,2006: p14.

過敏性腸症候群(IBS)の治療:第3段階

出典
img
1: 日本消化器病学会編:機能性消化管疾患診療ガイドライン2020―過敏性腸症候群(IBS)改訂第2版, p.xxii, 2020, 南江堂 より許諾を得て転載

過敏性腸症候群(IBS)のRome IV診断基準

他疾患が否定されれば、脳腸相関病(disorders of gut-brain interaction:DGBI)であり、Rome IV基準に基づいてIBSを診断する。IBSは、Bristol便形状尺度([ID0603])に基づいて4型に便宜的に分類する([ID0605])。Rome IVのIBS診断基準を満たさなければ、IBS以外のDGBIである。腹痛のない便秘は機能性便秘、腹痛のない下痢は機能性下痢、便通異常のない腹痛は機能性腹痛症候群、便通異常のない腹部膨満感は機能性腹部膨満、いずれでもなければ非特異機能性腸疾患である。Rome IVは2016年に公刊された。
出典
imgimg
1: Bowel Disorders.
著者: Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R.
雑誌名: Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epub 2016 Feb 18.
Abstract/Text: Functional bowel disorders are highly prevalent disorders found worldwide. These disorders have the potential to affect all members of society, regardless of age, gender, race, creed, color or socioeconomic status. Improving our understanding of functional bowel disorders (FBD) is critical as they impose a negative economic impact to the global health care system in addition to reducing quality of life. Research in the basic and clinical sciences during the past decade has produced new information on the epidemiology, etiology, pathophysiology, diagnosis and treatment of FBDs. These important findings created a need to revise the Rome III criteria for FBDs, last published in 2006. This manuscript classifies the FBDs into five distinct categories: irritable bowel syndrome (IBS); functional constipation (FC); functional diarrhea (FDr); functional abdominal bloating/distention (FAB/D); and unspecified FBD (U-FBD). Also included in this article is a new sixth category, opioid induced constipation (OIC) which is distinct from the functional bowel disorders (FBDs). Each disorder will first be defined, followed by sections on epidemiology, rationale for changes from prior criteria, clinical evaluation, physiologic features, psychosocial features and treatment. It is the hope of this committee that this new information will assist both clinicians and researchers in the decade to come.

Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.
Gastroenterology. 2016 Feb 18;. doi: 10.1053/j.gastro.2016.02.031. Epu...