Irritable bowel syndrome: A 10-yr natural history of symptoms and factors that influence consultation behavior
Irritable bowel syndrome: A 10-yr natural history of symptoms and factors that influence consultation behavior
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DOI：
10.1111/j.1572-0241.2007.01740.x
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发表时间：
2008-05-01
影响因子：
9.8
通讯作者：
Moayyedi, Paul
中科院分区：
文献类型：
--
作者：
Ford, Alexander C.;Forman, David;Moayyedi, Paul
目的：肠易激综合征（IBS）是一种慢性功能性胃肠道疾病。该疾病的自然史已被广泛研究，但很少有研究探讨了预测其新发或寻求医疗保健的行为的因素。pylori）通过邮寄问卷进行联系，使用用于IBS诊断的Manning标准。基线人口统计学数据、生活质量、IBS和消化不良症状数据已经存档。征求同意检查初级保健记录，和数据有关IBS和消化不良相关的consultations were extracted.RESULTS：最初涉及的8,407个人，3,873（46%）提供的症状数据在基线和10年的后续行动。在3，659名基线时没有IBS的个体中，542人（15%）在10年随访时出现了新发IBS。多因素Logistic回归分析显示，基线时生活质量较低（比值比[OR] 4.41，99%置信区间[CI] 2.92-6.65）、基线时消化不良（OR 1.77，99% CI 1.28-2.46）和女性（OR 2.14，99% CI 1.56-2.94）是新发IBS的重要危险因素。在基线或10年随访的651名IBS患者中，113人（17%）因症状咨询了初级保健医生。H.幽门螺杆菌感染（OR 1.93，99% CI 1.03-3.62）和任何消化不良相关咨询（OR 2.14，99%CI 1.15-4.00）显著增加了咨询的可能性。基线生活质量差是新发IBS的强预测因子，但不是IBS相关咨询行为的预测因子，这与研究期间的消化不良咨询有关。
OBJECTIVE: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. The natural history of the condition has been studied extensively, but few studies have examined factors that predict its new onset or health care-seeking behavior.METHODS: Individuals, now aged 50-59 yr, originally enrolled in a population-screening program for Helicobacter pylori (H. pylori) were contacted via postal questionnaire, utilizing the Manning criteria for IBS diagnosis. Baseline demographic data, quality of life, and IBS and dyspepsia symptom data were already on file. Consent to examine primary care records was sought, and data regarding IBS- and dyspepsia-related consultations were extracted.RESULTS: Of 8,407 individuals originally involved, 3,873 (46%) provided symptom data at baseline and 10-yr follow-up. Of 3,659 individuals without IBS at baseline, 542 (15%) developed new-onset IBS at 10-yr follow-up. After multivariate logistic regression, lower quality of life at baseline (odds ratio [OR] 4.41, 99% confidence interval [CI] 2.92-6.65), dyspepsia at baseline (OR 1.77, 99% CI 1.28-2.46), and female gender (OR 2.14, 99% CI 1.56-2.94) were significant risk factors for new-onset IBS. Of 651 individuals with IBS at either baseline or 10-yr follow-up, 113 (17%) consulted a primary care physician with symptoms. H. pylori infection (OR 1.93, 99% CI 1.03-3.62) and any dyspepsia-related consultation (OR 2.14, 99% CI 1.15-4.00) significantly increased the likelihood of consultation.CONCLUSIONS: Poor quality of life at baseline was a strong predictor of new-onset IBS, but not of IBS-related consultation behavior, which was associated with consultation for dyspepsia during the study period.