臨牀消化器内科 Vol.30 No.2(5-2)


特集名 機能性消化管疾患―病態の解明と新たな治療
題名 機能性消化管疾患の治療 (2) 過敏性腸症候群の薬物療法―腸管運動改善薬の効果
発刊年月 2015年 02月
著者 鳥居明 鳥居内科クリニック
【 要旨 】 過敏性腸症候群(IBS)の治療においては病態の説明,生活指導,食事指導,薬物療法,心理療法が柱となる.とくに薬物療法はIBS治療の主体となる.男性の下痢型IBSに対しては,5‒HT3拮抗薬(セロトニン受容体拮抗薬)であるラモセトロン塩酸塩が著効を示す.他の病型に対しては,高分子重合体であるポリカルボフィルカルシウムを主軸にし,症状により止痢薬,下剤を併用する.精神的要素の強い場合は抗不安薬も有用である.漢方薬もその有用性が認められる.IBSの診療においては,患者‒医師の信頼関係がきわめて重要である.
Theme Unraveling of the Pathophysiology of Functional Gastrointestinal Disorders and Updated Treatments
Title Pharmacologic Therapy for Patients with Irritable Bowel Syndrome (IBS)
Author Akira Torii Torii Medical Clinic
[ Summary ] Current treatment options for irritable bowel syndrome (IBS) are limited. Treatment includes education around the disease and its life cycle, advice on dietary modifications, a pharmacologic agent, and psychotherapy. One of the most effective treatment options for IBS is pharmacologic therapy. 5‒HT3 receptor antagonists are effective for male patients with IBS with diarrhea (IBS‒D). Laxatives are also effective for patients with IBS with constipation (IBS‒C). Polycarbophil calcium is the most common drug for patients with any subtypes of IBS. Antidiarrheal agents are effective for patients with IBS‒D.
Sedative agents are effective for IBS patients with anxiety. Herbal medicine is also sometimes effective for patients with IBS. The patient‒doctor relationship is key in the treatment of IBS.
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