肠脑相互作用紊乱(DGBI)的诊断、治疗和管理方面的创新。

IF 3.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Patrycja Krynicka, George Koulaouzidis, Wojciech Marlicz, Anastasios Koulaouzidis
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引用次数: 0

摘要

功能性消化不良(FD)和肠易激综合征(IBS)是肠脑相互作用(DGBI)最常见的疾病,经常重叠并与复杂的病理生理机制相关。越来越多的证据表明,肠道微生物群的改变通过免疫激活、运动性改变、肠道血管屏障和肠-脑轴破坏来驱动症状。涉及领域:本文综述了肠道微生物群在FD和IBS发病机制和症状学中的作用。使用PubMed、EMBASE和谷歌Scholar数据库进行了全面的文献检索,包括2013年1月至2025年3月之间发表的研究。特别关注微生物群靶向治疗,如益生元、益生菌、合成菌、后益生菌和粪便微生物群移植(FMT)。本文还讨论了结合饮食和生活方式改变、认知行为疗法和药理神经调节的多维治疗策略。诊断方法的最新进展,包括基于胶囊的微生物群采样和远程心理胃肠病学护理的数字工具,都得到了强调。专家意见:尽管科学进步,目前DGBI管理仍然不够个性化。未来的方法应该将个性化的微生物群分析与有针对性的干预措施结合起来,并利用创新的诊断和数字卫生技术来提高FD和IBS的临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Innovations in the diagnosis, treatment, and management of disorders of gut-brain interaction (DGBI).

Introduction: Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are the most prevalent disorders of gut-brain interaction (DGBI), frequently overlapping and associated with complex pathophysiological mechanisms. Increasing evidence implicates gut microbiota alterations in driving symptoms via immune activation, altered motility, gut vascular barrier and gut-brain axis disruption.

Areas covered: This review explores the role of gut microbiota in FD and IBS pathogenesis and symptomatology. A comprehensive literature search was conducted using PubMed, EMBASE, and Google Scholar databases, including studies published between January 2013 and March 2025. Particular focus is given to microbiota-targeted therapies such as prebiotics, probiotics, synbiotics, postbiotics, and fecal microbiota transplantation (FMT). The review also discusses multidimensional treatment strategies combining dietary and lifestyle modification, cognitive-behavioral therapy, and pharmacological neuromodulation. Recent advances in diagnostic methods, including capsule-based microbiota sampling and digital tools for remote psychogastroenterology care, are highlighted.

Expert opinion: Despite scientific progress, current DGBI management remains insufficiently personalized. Future approaches should integrate individualized microbiota profiling with targeted interventions and utilize innovative diagnostic and digital health technologies to enhance clinical outcomes in FD and IBS.

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来源期刊
Expert Review of Gastroenterology & Hepatology
Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.80
自引率
2.60%
发文量
86
审稿时长
6-12 weeks
期刊介绍: The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.
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