Irritable Bowel Syndrome : Its clinical characteristics and neuroendocrinological pathophysiology(Panic Disorder)

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  • Namiki Masayoshi
    Department of International Medicine (III), Asahikawa Medical College
  • Uehara Akira
    Department of International Medicine (III), Asahikawa Medical College

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  • 過敏性腸症候群を中心に : その臨床像と神経内分泌学的にみた病態生理(Panic Discover をめぐって)(第30回日本心身医学会総会)

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Abstract

Irritable bowel syndrome (IBS) is a typical functional disorder in the gastrointestinal tract that frequently develops under psychologically stressful conditions including panic. In relation to panic disorder, we first described a few interesting clinical aspects of IBS that were mainly based upon our clinical study on 152 refugees at the time of Takachi Earthquake in 1968. Many refugees dedveloped abnormal bowel movements and related abdominal symptoms, and their disturbed patterns of defecation showed a significant change during a course of time. In brief, diarrhea was predominantly manifest during the early period, and constipation or alternate diarrhea/constipation became evident in later periods. A follow-up study carried out a year after the earthquake revealed that some refugees had developed into clinical states which could be diagnosed as IBS. We next demonstrated the results of an animal stress experiment that was performed, using a newly-developed stress model, in order to address an neuroendocrine mechanism for IBS. The results in the study strongly suggest that corticotropin-releasing factor, a neuropeptide which regulates various stress responses, is closely involved in the development of stress-induced bowel distrubances similar to IBS. These findings indicate that it is possible that the pathophysiology of IBS may be elucidated from a neuroendocrine point of view, as well.

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