Lower functional gastrointestinal disorders: evidence of abnormal colonic transit in a 287 patient cohort.

Lower functional gastrointestinal disorders: evidence of abnormal colonic transit in a 287 patient cohort.
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DOI:
10.1111/j.1365-2982.2009.01442.x
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发表时间:
2010-03
影响因子:
3.5
通讯作者:
Zinsmeister AR
Zinsmeister AR
中科院分区:
医学3区
文献类型:
--
作者:
Manabe N;Wong BS;Camilleri M;Burton D;McKinzie S;Zinsmeister AR

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在包括肠易激综合征(IBS)在内的低功能胃肠道疾病(FGID)患者的相对较小的研究中报道了结肠运动异常。性别和体重对观察到的运动病理生理的影响尚不清楚。比较不同低FGID亚组患者和健康对照者的结肠运输,控制性别和BMI,并确定BMI是否独立影响结肠运动。我们评估了287例与便秘(IBS-C或功能性便秘,n=118)、腹泻(IBS-D或功能性腹泻,n=139)或混合肠功能(IBS-M, n=30)相关的低FGID患者和170名健康对照者的胃肠道和结肠运输扫描数据库。我们在6小时(CF 6h)测量结肠充盈,在8小时、24小时和48小时测量总体结肠运输。6小时时的CF不能区分健康和FGID。在所有低FGID患者中,29.7%的患者24小时结肠运输异常(GC24 <1.50或>3.86)。结肠转运与受试者组(健康对照组和FGID亚组)在8小时(P=0.01)、24小时(P<0.001)和48小时(P<0.001)之间存在显著的总体关联,特别是在24小时和48小时出现腹泻或便秘的患者(P< 0.05),即使在调整了年龄、性别和BMI之后也是如此。此外,在调整年龄、性别和受试者组后,BMI与结肠运输相关。在30%的低FGID患者中,无创显像记录了异常转运;过境测量可能有助于记录下FGID的病理生理学和告知治疗选择。
Abnormalities of colonic motility were reported in relatively small studies of patients with lower functional gastrointestinal disorders (FGID) including irritable bowel syndrome (IBS). The influence of gender and body mass on the observed motor pathophysiology is unclear. To compare colonic transit in patients with different lower FGID subgroups and healthy controls, controlling for gender and BMI, and to determine whether BMI independently influences colonic motility. We evaluated a scintigraphic gastrointestinal and colonic transit database of 287 lower FGID patients associated with constipation (IBS-C, or functional constipation, n=118), diarrhea (IBS-D or functional diarrhea, n=139) or mixed bowel function (IBS-M, n=30) and 170 healthy controls. We measured colon filling at 6 hours (CF 6h), and overall colonic transit at 8, 24, and 48 hours. CF at 6h did not differentiate health from FGID. Colonic transit was abnormal at 24 hours (GC24 of <1.50 or >3.86) in 29.7% of all lower FGID patients. There was a significant overall association between colonic transit and subject group (healthy controls and FGID subgroups) at 8 (P=0.01), 24 (P<0.001) and 48 hours (P<0.001) in particular for those with diarrhea or constipation at 24 and 48 hours (P <0.05), even after adjusting for age, gender, and BMI. In addition, BMI was associated with colonic transit after adjusting for age, gender and subject group. Abnormal transit is documented noninvasively with scintigraphy in 30% of lower FGID patients; transit measurement may help document pathophysiology and inform selection of therapy in lower FGID.
DOI: 10.1001/jama.288.14.1723
发表时间: 2002-10-09
影响因子: 120.7
作者:
Flegal, KM;Carroll, MD;Johnson, CL
通讯作者: Johnson, CL
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发表时间: 2008-05-29
影响因子: 158.5
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DOI: 10.1016/0016-5085(92)91092-i
发表时间: 1992-07-01
期刊: GASTROENTEROLOGY
影响因子: 29.4
作者:
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通讯作者: ZINSMEISTER, AR