INTESTINE Vol.21 No.4(3-1)


特集名 腸内細菌をめぐって
題名 機能性胃腸症と腸内細菌(1)過敏性腸症候群の病態における腸内細菌の役割
発刊年月 2017年 07月
著者 福土 審 東北大学大学院医学系研究科行動医学・東北大学病院心療内科
【 要旨 】 過敏性腸症候群(irritable bowel syndrome ; IBS)の病態に腸内細菌が大きく関与している可能性が高くなっている.感染性腸炎後にIBSが発症し,IBSの腸内細菌組成も健常者と異なる.IBS糞便中の短鎖脂肪酸の濃度は消化器症状,quality of life,性格傾向まで影響している.ストレスは腸内細菌組成を変容させ,粘膜透過性亢進と内臓知覚過敏を招き,IBSの病態に沿った病理変化を起こす.IBSの腸内細菌を変容させ,症状が改善する場合には,同時に抑うつを中心とする中枢機能が改善する.脳腸相関に沿ったIBSの腸内細菌のさらなる検討が有望である.
Theme Impacts of intestinal microbiota
Title Role of gut microbiota in pathophysiology of irritable bowel syndrome
Author Shin Fukudo Department of Behavioral Medicine, Tohoku University Graduate School of Medicine
[ Summary ] Recent advances in studies pertaining to irritable bowel syndrome (IBS) have demonstrated that microbiota might play a crucial role in its pathophysiology. IBS is triggered by acute bacterial infection of the gut. Gut microbiota identifi ed in IBS patients differ from organisms found in healthy controls. Fecal concentration of short chain fatty acids is proportional to gastrointestinal symptoms, quality of life, and Factor 3 on the alexithymia scale. Stress alters the composition of gut microbiota, increases mucosal permeability, and sensitizes visceral perception thereby mimicking features of IBS. Interventions directed toward gut microbiota not only improve IBS symptoms but are also seen to improve negative emotions including depression. Further analyses of gut microbiota in IBS are warranted.
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