Significance of disorders of brain-gut interaction in the diagnosis and management of refractory constipation
10.3760/cma.j.cn441530-20240328-00113
- VernacularTitle:脑肠互动异常在顽固性便秘诊治中的意义
- Author:
Bowen TIAN
1
;
Tao JIN
;
Xue SU
;
Xuzhao LI
;
Zhifeng ZHAO
Author Information
1. 宁夏回族自治区人民医院普通外科中心，银川 750000
- Publication Type:Journal Article
- Keywords:
Refractory constipation;
Disorders of brain-gut interaction;
Chronic constipation;
Gut-brain axis
- From:
Chinese Journal of Gastrointestinal Surgery
2024;27(12):1301-1308
- CountryChina
- Language:Chinese
-
Abstract:
Chronic constipation is a common digestive disease that affects people's quality of life, with complex causes and difficult treatment. Nearly half of the patients with chronic constipation do not achieve satisfactory treatment results, which is referred to as refractory constipation.Current clinical strategies for addressing refractory constipation have predominantly focused on the mitigation of intestinal symptoms. However, emerging evidence suggests that the pathogenesis and progression of refractory constipation are multifactorial and highly intricate, and that strategies targeted solely at symptom relief may be insufficient to yield optimal therapeutic outcomes. Based on the concept of disorders of brain gut interaction disorder (DBGI) proposed by Rome IV, we found that DBGI may play a key role in patients with refractory constipation. From the perspective of DBGI, this review synthesized the contemporary insights into the pathological mechanisms underlying refractory constipation, as well as diagnostic and therapeutic strategies focusing on four aspects: the central nervous system, the peripheral nervous system, the endocrine system, and the intestinal environment.
