臨牀消化器内科 Vol.19 No.13(5)


特集名 消化器疾患と食事
題名 生活習慣病にみられる消化器異常
発刊年月 2004年 12月
著者 竹林 晃一 防衛医科大学校第二内科
著者 三浦 総一郎 防衛医科大学校第二内科
【 要旨 】 生活習慣病は偏った生活習慣要因が引き金になって発症し,消化器にもさまざまな影響を及ぼす.糖尿病ではdiabetic gastroparesisのほか下痢・便秘,膵炎,胆石症など多岐にわたる消化管合併症がみられる.NASH (非アルコール性脂肪性肝炎) はしばしば肝硬変をきたし肝癌の発生母地となるので,脂肪肝をすべて良性の疾患として看過してはいけない.虚血性大腸炎はとくに高齢者では動脈硬化との関連が深く,その病因は腸管内腔圧上昇を介して血流障害に関連する腸管側因子と直接血流障害に関連する血管側因子に大別される.生活習慣病予防の基本は包括的生活習慣病リスクの低減であり,またその治療と予防は密接な関係にある.そのなかで,食生活の改善は予防および治療に共通した重要なファクターであると考えられる.
Theme Diet as Etiologic Factors and Therapeutic Tools in Digestive Diseases
Title Digestive Disorders in Lifestyle-Related Diseases
Author Koichi Takebayashi Second Department of Internal Medicine, National Defense Medical College
Author Soichiro Miura Second Department of Internal Medicine, National Defense Medical College
[ Summary ] Lifestyle-related diseases are caused or accelerated by lifestyles such as eating habits, lack of exercise and relaxation, smoking, and drinking. These diseases include diabetes mellitus, hypertension, hyperlipidemia, obesity, cancer, arteriosclerosis and so on. They exert various influences on digestive system. Diabetic patients sometimes have digestive disorders such as, diabetic gastroparesis, diarrhea, constipation, pancreatitis, gallstones, and cholecystitis. Patients with simple fatty liver will take a benign clinical course. But nonalcoholic steatohepatitis (NASH) may occasionally progress to fibrosis or cirrhosis, then liver-related death. Hepatocellular carcinoma may represent a late complication of NASH-related cirrhosis. Ischemic colitis is closely related to arteriosclerosis especially in elderly patients, and its causes are classified into intestinal factors which have an influence on blood flow disorder through increase in the inner pressure of the intestine, and vascular factors which directly obstruct blood flow. The key to prevention of lifestyle-related diseases is the comprehensive reduction of their risks. Treatment of lifestyle-related diseases also closely relate to their prevention. And it should be noted that changing the dietary habits may play a central role for their prevention and treatment.
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