Sermin KESEBİR, Semra Ocak KARATAŞ, Çiğdem BEZGİN, Fatma CENGİZ

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Stres, Anksiyete ve Fonksiyonel Gastrointestinal Bozukluklar

Stresin fonksiyonel gastointestinal sistem bozukluklarında major bir rolü vardır. Bu durumun en tipik örneği irritabl barsak sendromudur. Akut ya da kısa süreli strese gastrointestinal sistem yanıtı, gastrik boşalmanın gecikmesi ve kolonik geçişin uyarılması şeklindedir. CRF2 reseptörleri, üst kısımdaki inhibisyona aracılık ederken, CRF1 alt kısımda kolonik ve anksiyojenik yanıttan sorumludur. Visseral hipersensitivite emosyonel motor sistem tarafından yönetilmekte, en belirgin rolü amigdala oynamakta ve mukozal mast hücrelerinde ortaya çıkmaktadır. Fakat fonksiyonel gastrointestinal yakınmaları olan kişilerde motilite yanıtının, sağlıklı bireylerden nasıl farklılaştığı, bu durumun otonom sinir sistemindeki bir yetersizlikten mi yoksa artmış bir stres duyarlılığından mı kaynaklandığı yeterince anlaşılmış değildir. Beyin-gastrointestinal sistem ekseninde negatif emosyon belirti sıklığı ve şiddeti ile ilişkilidir. Amerikan Gastroentereloglar Birliği, yaşam kalitesi ile yakından ilişkili ve tedavisi oldukça güç olan gastrointestinal bozuklukların belirtilerini, boyutsal olarak bir araya getirmiş, ‘’Gastrointestinal Distres’’ başlığı altında yeniden yorumlamıştır. Bu yorum gastrointestinal distres olarak tanımlanan durumu, fiziksel, emosyonel ve davranışsal bileşenleri olan bir bozukluk olarak, adeta bir anksiyete bozukluğu gibi ele almaktadır. Fiziksel bileşen, ağrı, gaz ve defekasyon sorunları, bilişsel bileşen, dışsal odakların kontrolü, katastrofizasyon ve beklenti anksiyetesi, emosyonel bileşen ise bedensel anksiyete, hipervijilans ve gastrointestinal uyaranlardan kaçınma şeklinde tanımlanmıştır.
Anahtar Kelimeler:

Stres, anksiyete, gastrointestinal belirtiler

Stress, Anxiety and Functional Gastrointestinal Disorders

Stress has major role in functional gastrointestinal system disorders. The most typical example of this situation is Irritable bowel syndrome. Gastrointestinal system’s response to acute or short-term of stress is delay of gastric emptying and stimulation of colonic transition. While CRF2 receptors are mediate the upper section inhibition, CRF1 is responsible for the lower part colonic and anxiogenic response. Visceral hypersensitivity is managed by the emotional motor system, the amygdala plays a significant role and mucosal mast cells arise. But in people with symptoms of functional gastrointestinal, how is differ motility response in healthy individuals, this situation is due to lack of autonomous nervous system or an increased sensitivity of stress is not adequately understood. The brain-gastrointestinal axis frequency and severity of symptoms associated with negative emotions. American Gastroenterology Association is closely associated with the quality of life and is very difficult to treat the symptoms of gastrointestinal disorders, re-interpreted under the heading of 'Gastrointestinal Distress'. This review is defined as gastrointestinal distresses, physical, emotional, and behavioral components as a disorder in which, almost like an anxiety disorder are discussed. Physical component is pain, gas, and defecation problems, cognitive component is external foci control, catastrophization and anticipatory anxiety, the emotional component is somatic anxiety, hypervigilance, and avoidance of gastrointestinal stimuli as defined.
Keywords:

stress, anxiety, gastrointestinal symptoms,

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Arşiv Kaynak Tarama Dergisi-Cover
  • ISSN: 1300-3755
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1992
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi
Arşiv
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Ümit YAŞAR, Pınar Yılgör HURİ, Nurten DİKMEN

Stres, Anksiyete ve Fonksiyonel Gastrointestinal Bozukluklar

Sermin KESEBİR, Semra Ocak KARATAŞ, Çiğdem BEZGİN, Fatma CENGİZ