Bowel urgency in patients with irritable bowel syndrome
Bowel urgency in patients with irritable bowel syndrome
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DOI：
10.1053/j.gastro.2006.10.029
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发表时间：
2007-01-01
期刊：
影响因子：
29.4
通讯作者：
Cesana, Bruno Mario
中科院分区：
文献类型：
--
作者：
Basilisco, Guido;De Marco, Elisabetta;Cesana, Bruno Mario
背景和目标：肠紧迫感是肠易激综合征腹泻患者最令人烦恼的症状，但其病理生理机制知之甚少。我们的目的是评估报告症状，结肠和直肠的储库功能，以及患者的心理状况之间的关系。方法：研究包括28例肠易激综合征患者和17名健康受试者。在摄入不透射线标记物所需的3天内，通过问卷调查验证是否存在肠紧迫感。在第四天，腹部X线检查评估结肠通过时间，并在直肠扩张期间测量直肠感觉和运动反应。受试者的心理概况进行了评估，使用心理症状检查表。结果：46%的患者报告与至少一次排便相关的紧迫感。多变量logistic回归分析显示，结肠转运是与报告的肠紧迫感独立相关的唯一变量，但由于其临界显著性水平，因此未从模型中删除紧迫感的阈值。直肠顺应性与直肠扩张期间的紧迫感阈值密切相关，但不是报告紧迫感的独立因素。有和没有紧迫感的患者表现出改变的心理特征。结论：肠易激综合征患者的尿急症状与结肠和直肠储库的客观改变有关。
Background & Aims: Bowel urgency is the most bothersome symptom in irritable bowel syndrome patients with diarrhea, but its pathophysiology is poorly understood. Our aim was to assess the relationships among reporting the symptom, the reservoir functions of the colon and rectum, and the patients' psychologic profile. Methods: The study involved 28 consecutive patients with irritable bowel syndrome and 17 healthy subjects. The presence or absence of bowel urgency was verified by means of a questionnaire during the 3 days required for the ingestion of radio-opaque markers. On the fourth day, an abdominal x-ray was taken to assess colonic transit time, and rectal sensory and motor responses were measured during rectal distention. The subjects' psychologic profiles were assessed using a psychologic symptoms checklist. Results: Forty-six percent of the patients reported urgency associated with at least 1 defecation. The multivariate logistic regression analysis showed that colonic transit was the only variable independently associated with reported bowel urgency, but the threshold for the sensation of urgency was not removed from the model since its borderline significance level. Rectal compliance was closely associated with the threshold for the sensation of urgency during rectal distention but was not an independent factor for reporting the sensation. The patients with and without urgency showed altered psychologic profiles. Conclusions: The symptom of urgency is associated with objective alterations in the colonic and rectal reservoir of patients with irritable bowel syndrome.