From a pure motor disorder of the bowel,in the past few years,irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity,alterations at the level of nervous and humoral c...From a pure motor disorder of the bowel,in the past few years,irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity,alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system,alteration of the gut microflora,an increased intestinal permeability and minimum intestinal inflammation.Psychological and social factors can interfere with the communication between the central and enteric nervous systems,and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome.There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders.In order to explain clustering of IBS in families,genetic factors and social learning mechanisms have been proposed.The psychological features,such as anxiety,depression as well as the comorbid psychiatric disorders,health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.展开更多
AIM： To investigate the hypothesis that duodenal bulb （DB） inhibition on pyloric antrum （PA） contraction is reflex. METHODS： Balloon （condom）-tipped tube was introduced into 1^st duodenum （DD） and a manometr...AIM： To investigate the hypothesis that duodenal bulb （DB） inhibition on pyloric antrum （PA） contraction is reflex. METHODS： Balloon （condom）-tipped tube was introduced into 1^st duodenum （DD） and a manometric tube into each of PA and DD. Duodenal and antral pressure response to duodenal and then PA balloon distension with saline was recorded. These tests were repeated after separate anesthetization of DD and PA. RESULTS： Two and 4 mL of 1^st DD balloon distension produced no pressure changes in DD or PA （10.7±1.2 vs 9.8±1.2, 11.2±1.2 vs 11.3±1.2 on H20 respectively, P〉0.05）. Six mL distension effected 1^st DD pressure rise （30.6±3.4 cm H20, P 〈0.01） and PA pressure decrease （6.2±1.4 cm H20, P〈0.05）; no response in 2^nd, 3^rd and 4^th DD. There was no difference between 6, 8, and 10 mL distensions. Ten mL PA distension produced no PA or 1^st DD pressure changes （P〉 0.05）. Twenty mL distension increased PA pressure （92.4 4±10.7 cm H20, P〈0.01） and decreased 1^st DD pressure （1.6±0.3 cm H20, P〈0.01）; 30, 40, and 50 mL distension produced the same effect as the 20 mL distension （P 〉 0.05）. PA or DD distension after separate anesthetization produced no significant pressure changes in PA or DD. CONCLUSION： Large volume DD distension produced DD pressure rise denoting DD contraction and PA pressure decline denoting PA relaxation. PA relaxation upon DD contraction is postulated to be mediated through a reflex which we call duodeno-antral reflex. Meanwhile, PA distension effected DD relaxation which we suggest to be reflex and termed antro-duodenal reflex. It is suggested that these 2 reflexes, could act as investigative tools in diagnosis of gastroduodenal motility disorders.展开更多
基金Supported by The Sectorial Operational Programme Human Resources Development,Contract POSDRU 6/1.5/S/3-,Doctoral studies: through science towards society
文摘From a pure motor disorder of the bowel,in the past few years,irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity,alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system,alteration of the gut microflora,an increased intestinal permeability and minimum intestinal inflammation.Psychological and social factors can interfere with the communication between the central and enteric nervous systems,and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome.There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders.In order to explain clustering of IBS in families,genetic factors and social learning mechanisms have been proposed.The psychological features,such as anxiety,depression as well as the comorbid psychiatric disorders,health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.
文摘AIM： To investigate the hypothesis that duodenal bulb （DB） inhibition on pyloric antrum （PA） contraction is reflex. METHODS： Balloon （condom）-tipped tube was introduced into 1^st duodenum （DD） and a manometric tube into each of PA and DD. Duodenal and antral pressure response to duodenal and then PA balloon distension with saline was recorded. These tests were repeated after separate anesthetization of DD and PA. RESULTS： Two and 4 mL of 1^st DD balloon distension produced no pressure changes in DD or PA （10.7±1.2 vs 9.8±1.2, 11.2±1.2 vs 11.3±1.2 on H20 respectively, P〉0.05）. Six mL distension effected 1^st DD pressure rise （30.6±3.4 cm H20, P 〈0.01） and PA pressure decrease （6.2±1.4 cm H20, P〈0.05）; no response in 2^nd, 3^rd and 4^th DD. There was no difference between 6, 8, and 10 mL distensions. Ten mL PA distension produced no PA or 1^st DD pressure changes （P〉 0.05）. Twenty mL distension increased PA pressure （92.4 4±10.7 cm H20, P〈0.01） and decreased 1^st DD pressure （1.6±0.3 cm H20, P〈0.01）; 30, 40, and 50 mL distension produced the same effect as the 20 mL distension （P 〉 0.05）. PA or DD distension after separate anesthetization produced no significant pressure changes in PA or DD. CONCLUSION： Large volume DD distension produced DD pressure rise denoting DD contraction and PA pressure decline denoting PA relaxation. PA relaxation upon DD contraction is postulated to be mediated through a reflex which we call duodeno-antral reflex. Meanwhile, PA distension effected DD relaxation which we suggest to be reflex and termed antro-duodenal reflex. It is suggested that these 2 reflexes, could act as investigative tools in diagnosis of gastroduodenal motility disorders.
