Influence of abuse history on gastric sensorimotor function in functional dyspepsia
Influence of abuse history on gastric sensorimotor function in functional dyspepsia
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DOI：
10.1111/j.1365-2982.2008.01178.x
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发表时间：
2009-01-01
影响因子：
3.5
通讯作者：
Tack, J.
中科院分区：
文献类型：
--
作者：
Geeraerts, B.;van Oudenhove, L.;Tack, J.
功能性胃肠疾病患者性虐待或身体虐待的发生率升高，这可能与肠易激综合征患者直肠感觉运动功能改变有关。目的：探讨功能性消化不良（FD）患者滥用史与胃感觉运动功能的关系。我们研究了233例来自三级护理中心的连续FD患者（162名女性，平均年龄41.6 ± 0.9岁）的胃感觉运动功能，其中包括恒压器（敏感性，顺应性和适应性）和胃排空试验。患者填写了关于儿童或成年期性虐待和身体虐待史的自我报告问卷。84例患者（198例，42.4%）报告了总体虐待史[性虐待和身体虐待分别占30.0%（60/200）和20.3%（42/207）]。FD患者报告的一般以及严重的儿童期性虐待在胃扩张期间的不适阈值显著较低[分别为高于最小扩张压（MDP）10.5 +/- 0.4 vs 7.5 +/- 1.0 mmHg，P = 0.014和高于MDP 10.5 +/- 0.4 vs 6.6 +/- 1.2 mmHg，P = 0.007]。相应的球囊内体积也显著较低（分别为579 +/- 21 vs 422 +/- 59 mL，P = 0.013和579 +/- 19 vs 423 +/- 79 mL，P = 0.033）。在成年期报告强奸的患者中，胃调节明显更明显（91 +/- 12 vs 130 +/- 40 mL，P = 0.016）。滥用史与胃排空差异无关。滥用史与FD患者胃感觉运动功能的改变有关。特别是性虐待，而不是身体虐待，可能会影响胃的敏感性和运动功能。
Patients with functional gastrointestinal disorders have elevated rates of sexual or physical abuse, which may be associated with altered rectal sensorimotor function in irritable bowel syndrome. The aim was to study the association between abuse history and gastric sensorimotor function in functional dyspepsia (FD). We studied gastric sensorimotor function with barostat (sensitivity, compliance and accommodation) and gastric emptying test in 233 consecutive FD patients from a tertiary care centre (162 women, mean age 41.6 +/- 0.9). Patients filled out self-report questionnaires on history of sexual and physical abuse during childhood or adulthood. Eighty-four patients (out of 198, 42.4%) reported an overall history of abuse [sexual and physical in respectively 30.0% (60/200) and 20.3% (42/207)]. FD patients reporting general as well as severe childhood sexual abuse have significantly lower discomfort thresholds during gastric distension [respectively 10.5 +/- 0.4 vs 7.5 +/- 1.0 mmHg above minimal distending pressure (MDP), P = 0.014 and 10.5 +/- 0.4 vs 6.6 +/- 1.2 mmHg above MDP, P = 0.007]. The corresponding intra-balloon volume was also significantly lower (respectively 579 +/- 21 vs 422 +/- 59 mL, P = 0.013 and 579 +/- 19 vs 423 +/- 79 mL, P = 0.033). Gastric accommodation was significantly more pronounced in patients reporting rape during adulthood (91 +/- 12 vs 130 +/- 40 mL, P = 0.016). Abuse history was not associated with differences in gastric emptying. A history of abuse is associated with alterations in gastric sensorimotor function in FD. Particularly sexual abuse, rather than physical abuse, may influence gastric sensitivity and motor function.