Irritable pouch syndrome: a new category of diagnosis for symptomatic patients with ileal pouch-anal anastomosis.
Irritable pouch syndrome: a new category of diagnosis for symptomatic patients with ileal pouch-anal anastomosis.
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储袋易激综合征：针对有症状的回肠储袋-肛门吻合术患者的一种新诊断类型。
DOI：
10.1111/j.1572-0241.2002.05617.x
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Fazio,VictorW
中科院分区：
文献类型：
--
作者：
Shen,Bo;Achkar,Jean-Paul;Lashner,BretA;Ormsby,AdrianH;Brzezinski,Aaron;Soffer,EdyE;Remzi,FezaH;Bevins,CharlesL;Fazio,VictorW
目的：眼袋炎通常仅根据症状进行诊断。然而，大便次数增加，尿急和腹痛可能是由于类似肠易激综合征的情况。本研究的目的是评估肠道症状的病因，使用袋炎疾病活动指数（PDAI）。方法：症状，内窥镜检查和组织学进行了评估，在61个连续的症状性溃疡性结肠炎患者回肠袋肛门吻合术后。袋炎定义为PDAI评分≥ 7分，气囊炎定义为直肠袖的内镜和组织学炎症，而袋无炎症，袋易激综合征（IPS）定义为PDAI < 7且无气囊炎的症状。结果：31例患者（50.8%）有袋炎，4例（6.5%）有气囊炎，26例（42.6%）有IPS。三组的人口统计学特征相似。大便次数增加、尿急和腹部绞痛是三组中最常见的症状。直肠出血仅见于袖口炎（p< 0.001）。三组患者均无发热。27例（87.1%）结肠袋炎患者对2周疗程的环丙沙星或甲硝唑有反应，PDAI评分降低≥ 3。所有4例袖口炎患者均对局部氢化可的松或美沙拉嗪有反应，PDAI症状评分降低≥ 1。12例IPS患者（46.2%）对抗结肠炎、抗胆碱能和/或抗抑郁治疗有反应，PDAI症状评分降低≥ 1，而其余患者尽管接受了治疗，但症状仍持续存在。结论：大量回肠贮袋-肛门吻合术后有症状的患者不符合贮袋炎或袖套炎的诊断标准，并被归类为IPS。有一个重叠的症状之间的患者袋炎，袖口炎，和IPS，内镜评价可以区分这些群体。区分这三组具有治疗意义。
OBJECTIVE:Pouchitis often is diagnosed based on symptoms alone. However, increased stool frequency, urgency, and abdominal pain could be due to a condition resembling irritable bowel syndrome. This study was designed to assess the etiology of bowel symptoms using the Pouchitis Disease Activity Index (PDAI).METHODS:Symptoms, endoscopy, and histology were assessed in 61 consecutive symptomatic patients with ulcerative colitis after ileal pouch-anal anastomosis. Pouchitis was defined as a PDAI score of≥ 7, cuffitis was defined as endoscopic and histological inflammation of the rectal cuff and no inflammation of the pouch, and irritable pouch syndrome (IPS) was defined as symptoms with a PDAI of< 7 and the absence of cuffitis.RESULTS:Thirty-one patients (50.8%) had pouchitis, four (6.5%) had cuffitis, and 26 (42.6%) had IPS. Demographics were similar in the three groups. Increased stool frequency, urgency, and abdominal cramps were the most common symptoms in the three groups. Rectal bleeding was seen only in cuffitis (p< 0.001). No patient in the three groups had fever. Twenty-seven patients (87.1%) with pouchitis responded to a 2-wk course of ciprofloxacin or metronidazole with a reduction in PDAI scores of≥ 3. All four patients with cuffitis responded to topical hydrocortisone or mesalamine with a reduction in the PDAI symptom component score of≥ 1. Twelve patients with IPS (46.2%) responded to antidiarrheal, anticholinergic, and/or antidepressant therapies with a reduction in the PDAI symptom component score of≥ 1, whereas the remaining patients had persistent symptoms despite therapy.CONCLUSIONS:A substantial number of symptomatic patients after ileal pouch-anal anastomosis do not meet the diagnostic criteria for either pouchitis or cuffitis and have been classified as having IPS. There is an overlap of symptoms among patients with pouchitis, cuffitis, and IPS, and endoscopic evaluation can differentiate among these groups. Distinction between these three groups has therapeutic implications.
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DOI：
--
发表时间：
1994
期刊：
影响因子：
--
作者：
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通讯作者：
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影响因子：
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作者：
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PHILLIPS, SF
DOI：
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1997
期刊：
The American journal of gastroenterology.
影响因子：
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作者：
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Mayer,EA
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影响因子：
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作者：
W. Kmiot;S. Hesslewood;N. Smith;H. Thompson;L. K. Harding;M. Keighley
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影响因子：
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作者：
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通讯作者：
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