臨牀消化器内科 Vol.18 No.4(5)


特集名 Non-ulcer Dyspepsiaの診断・治療
題名 胃排出能検査法
発刊年月 2003年 04月
著者 中田 浩二 東京慈恵会医科大学外科
著者 川崎 成郎 東京慈恵会医科大学外科
著者 高橋 朋子 東京慈恵会医科大学外科
著者 梁井 真一郎 東京慈恵会医科大学外科
著者 梶本 徹也 東京慈恵会医科大学外科
著者 羽生 信義 東京慈恵会医科大学外科
【 要旨 】 機能性消化管疾患として注目が高まっているfunctional dyspepsia(FD)において,胃排出遅延がおもな病因の一つとされている.FD患者に対して胃排出能検査を行うことは,その病態を把握し治療法選択に役立てたり,治療効果を判定するうえで有用と考えられる.臨床的にさまざまな胃排出能検査法が行われているが,その特徴を十分理解したうえで適切に用いる必要がある.13C法は近年急速に広まりつつある非侵襲的,簡便で信頼性の高い胃排出能検査法であり,多施設共同検討による「標準案」が提唱されその普及が進行しつつある.胃排出異常を簡便に診断しうる胃排出能検査法の普及により,FD患者の病態解明も大きく前進することが期待される.
Theme Diagnosis and Treatment of Non-ulcer Dyspepsia
Title Gastric Emptying Study for Functional Dyspepsia Patients
Author Koji Nakada Department of Surgery, Jikei University School of Medicine
Author Naruo Kawasaki Department of Surgery, Jikei University School of Medicine
Author Tomoko Takahashi Department of Surgery, Jikei University School of Medicine
Author Shinichiro Yanai Department of Surgery, Jikei University School of Medicine
Author Tetsuya Kajimoto Department of Gastroenterology, Miyoshi General Hospital
Author Nobuyoshi Hanyu Department of Surgery, Jikei University School of Medicine
[ Summary ] Delayed or rapid gastric emptying is common in patients with various abdominal symptoms or with gastrointestinal function disorders. Delayed gastric emptying is considered as a major form of path ogenesis in patients with functional dyspepsia. For these patients, gastric emptying studies seem useful in understanding the causes of symptoms or to evaluate the efficacy of drugs.
Various gastric emptying studies have been applied in clinical settings, however, special attention is required when one is choosing the proper method. Gastric emptying study made using a 13C-breath test, is thought of as producing non-invasive, simple and reliable method which have become widespread. In Japan, a standardized method for the 13C-breath test has been proposed, as a result of a cooperative study by nine institutions. By introducing standardized method, the benefits may be such things as, (1) avoiding being puzzled by details of the method, (2) enabling us to assess abnormal gastric emptying immediately, by comparing with the normal range of open data, (3) enable us to compare our data with other institutions' and to discuss this data with each other. Progress in better understanding the pathogenesis of functional dyspepsia patients may be achieved by the wide spread implementation of this easy and useful standardized method.
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