EPIDEMIOLOGY OF COLONIC SYMPTOMS AND THE IRRITABLE-BOWEL-SYNDROME
EPIDEMIOLOGY OF COLONIC SYMPTOMS AND THE IRRITABLE-BOWEL-SYNDROME
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DOI：
10.1016/0016-5085(91)90717-y
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发表时间：
1991-10-01
期刊：
影响因子：
29.4
通讯作者：
MELTON, LJ
中科院分区：
文献类型：
--
作者：
TALLEY, NJ;ZINSMEISTER, AR;MELTON, LJ
功能性胃肠道疾病被认为是非常常见的，但其患病率的报告通常没有评估随机社区样本，有效的问卷调查没有被用来引出症状。从特定人群中确定了具有代表性的中年白人中特定结肠症状和肠易激综合征的患病率，并测量了这些症状对医疗护理的影响。一个年龄和性别分层的1021名居民的奥姆斯特德县，明尼苏达州，年龄在30-64岁，随机样本。所有受试者都邮寄了一份有效的自我报告问卷，以确定胃肠道症状和功能性胃肠道疾病。有效率为82%（n = 835）。年龄和性别校正的腹痛患病率（前一年超过6次）为26.2/100（95%置信区间，23.1-29.2）。慢性便秘（硬便和用力和/或< 3 stools per week >25%的时间）的患病率为17.4（95%置信区间，14.8-20.0），而慢性腹泻（稀水样便和/或> 3次/天> 25%的时间）的患病率为17.9（95%置信区间，15.3-20.5）。女性和男性的腹痛和排便紊乱的患病率相似，但女性排便不频繁和排便困难更常见。使用曼宁症状标准确定肠易激综合征（前一年腹痛超过6次的患者中6种症状中≥ 2种），肠易激综合征的患病率为17.0/100（95%置信区间，14.4-19.6）。总体而言，71人（9%）报告在前一年因腹痛或排便紊乱就诊;调整年龄和性别后，与疼痛严重程度相关的变量子集是寻求医疗保健的最佳预测因素。然而，这些仅占对数可能性的22%。总之，超过三分之一的中年人报告慢性腹痛或排便障碍，超过六分之一的人有肠易激综合征的症状。只有少数人接受了医疗评估;此外，腹部疾病的特点并不能解释大多数情况下寻求保健的原因。
Functional gastrointestinal disease is believed to be very common, but reports of its prevalence have not usually evaluated random community samples, and validated questionnaires have not been used to elicit symptoms. The prevalence of specific colonic symptoms and the irritable bowel syndrome among representative middle-aged whites was determined from a defined population, and the impact of these symptoms on presentation for medical care was measured. An age-and sex-stratified random sample of 1021 residents of Olmsted County, Minnesota, aged 30–64 years, was obtained. All subjects were mailed a valid self-report questionnaire that identified gastrointestinal symptoms and functional gastrointestinal disorders. The response rate was 82% (n = 835). The age-and sex-adjusted prevalence of abdominal pain (more than six times in the prior year) was 26.2 per 100 (95% confidence interval, 23.1–29.2). The prevalence of chronic constipation (hard stools and straining and/or < 3 stools per week > 25% of the time) was 17.4 (95% confidence interval, 14.8–20.0), whereas the prevalence of chronic diarrhea (loose watery stools, and/or > 3 stools per day > 25% of the time) was 17.9 (95% confidence interval, 15.3–20.5). The prevalence of abdominal pain and disturbed defecation was similar in women and men, except that infrequent defecation and straining at stool were more common in women. Using the Manning symptom criteria to identify irritable bowel syndrome (≥ 2 of 6 symptoms in those with abdominal pain more than six times in the prior year), the prevalence of irritable bowel syndrome was 17.0 per 100 (95% confidence interval, 14.4–19.6). Overall, 71 persons (9%) reported visiting a physician for abdominal pain or disturbed defecation in the prior year; a subset of variables related to pain severity were the best predictors of health care seeking after adjustment for age and gender. However, these accounted for only 22% of the log likelihood. In conclusion, more than one third of an unselected middle-aged population reported chronic abdominal pain or disturbed defecation, and more than one in six had symptoms compatible with the irritable bowel syndrome. Only a minority had presented for medical evaluation; moreover, the characteristics of the abdominal complaints did not explain the seeking of health care in most cases.