Insights Into Normal and Disordered Bowel Habits From Bowel Diaries
Insights Into Normal and Disordered Bowel Habits From Bowel Diaries
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DOI：
10.1111/j.1572-0241.2007.01631.x
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发表时间：
2008-03-01
影响因子：
9.8
通讯作者：
Melton, L. Joseph, III
中科院分区：
文献类型：
--
作者：
Bharucha, Adil E.;Seide, Barbara M.;Melton, L. Joseph, III
背景技术背景：虽然症状问卷提供了排便习惯的快照，但它们可能无法反映日常变化或肠道症状与粪便形态之间的关系。目的：通过每日日记评估有和无功能性肠病的女性的排便习惯。方法：从明尼苏达州奥姆斯特德县的一项基于社区的调查中，278名随机选择的女性接受了胃肠病学家的采访，完成了肠道症状问卷调查受试者还保持2 wk.Results肠日记：在278名受试者中，问卷调查显示腹泻（26%），便秘（21%），或两者都没有（53%）。无症状受试者报告肠道症状（例如，紧急性）很少（即，< 25%的时间），通常用于硬或稀便。对于软的、成形的粪便的紧迫感（即，布里斯托型= 4）在腹泻（31%）和便秘（27%）受试者中的患病率高于正常受试者（16%）。大便形状、排便开始（比值比[OR] 4.1，95%置信区间[CI] 1.7-10.2）和排便结束（OR 4.7，95% CI 1.6-15.2）时用力增加便秘的几率。排便困难（OR 3.7，95% CI 1.2-12.0）、排便频率增加（OR 1.9，95% CI 1.02-3.7）、排便不完全（OR 2.2，95% CI 1.04-4.6）和直肠紧迫感（OR 3.1，95% CI 1.4-6.6）增加了腹泻的几率。相比之下，粪便的频率和形式的变化是没有用的健康和diseases.CONCLUSIONS：肠道症状的发生与粪便形式的障碍，但只有部分解释。这些观察结果支持了其他病理生理机制在功能性肠道疾病中的作用。(Am J Gastroenterol 2008;103：692-698）。
BACKGROUND: While symptom questionnaires provide a snapshot of bowel habits, they may not reflect day-to-day variations or the relationship between bowel symptoms and stool form.AIM: To assess bowel habits by daily diaries in women with and without functional bowel disorders.METHOD: From a community-based survey among Olmsted County, MN, women, 278 randomly selected subjects were interviewed by a gastroenterologist, who completed a bowel symptom questionnaire. Subjects also maintained bowel diaries for 2 wk.RESULTS: Among 278 subjects, questionnaires revealed diarrhea (26%), constipation (21%), or neither (53%). Asymptomatic subjects reported bowel symptoms (e.g., urgency) infrequently (i.e., < 25% of the time) and generally for hard or loose stools. Urgency for soft, formed stools (i.e., Bristol form = 4) was more prevalent in subjects with diarrhea (31%) and constipation (27%) than in normals (16%). Stool form, straining to begin (odds ratio [OR] 4.1, 95% confidence interval [CI] 1.7-10.2) and end (OR 4.7, 95% CI 1.6-15.2) defecation increased the odds for constipation. Straining to end defecation (OR 3.7, 95% CI 1.2-12.0), increased stool frequency (OR 1.9, 95% CI 1.02-3.7), incomplete evacuation (OR 2.2, 95% CI 1.04-4.6), and rectal urgency (OR 3.1, 95% CI 1.4-6.6) increased the odds for diarrhea. In contrast, variations in stool frequency and form were not useful for discriminating between health and disease.CONCLUSIONS: Bowel symptoms occur in association with, but are only partly explained by, stool form disturbances. These observations support a role for other pathophysiological mechanisms in functional bowel disorders.(Am J Gastroenterol 2008;103:692-698).