TOWARDS POSITIVE DIAGNOSIS OF IRRITABLE BOWEL
TOWARDS POSITIVE DIAGNOSIS OF IRRITABLE BOWEL
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DOI：
10.1136/bmj.2.6138.653
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发表时间：
1978-01-01
影响因子：
--
通讯作者：
MORRIS, AF
中科院分区：
文献类型：
--
作者：
MANNING, AP;THOMPSON, WG;MORRIS, AF
一份问卷调查确定了被认为是肠易激综合征(IBS)典型症状的15种症状的存在，109名未经选择的患者被转介到胃肠病科或外科诊所，这些患者有腹痛或大便习惯改变，或两者兼有。17-26个月后复查病历，明确诊断为IBS 32例，器质性疾病33例。在IBS患者中，有四种症状明显更为常见--即腹胀、通过排便缓解疼痛以及随着疼痛的出现而出现更多和更频繁的排便。粘液和不完全排空的感觉在这些患者中也很常见。出现的这些症状越多，患者的疼痛或排便习惯改变，或两者兼而有之，就越有可能是由IBS引起的。我们的结论是，仔细的病史可以增加诊断的信心，减少许多慢性腹痛患者的诊断量。
A questionnaire to establish the presence of 15 symptoms thought to be typical of the irritable bowel syndrome (IBS) was given to 109 unselected patients referred to gastroenterology or surgery clinics with abdominal pain or a change in bowel habit or both. Review of case records 17--26 months later established a definite diagnosis of IBS in 32 patients and of organic disease in 33. Four symptoms were significantly more common among patients with IBS--namely, distension, relief of pain with bowel movement, and looser and more frequent bowel movements with the onset of pain. Mucus and a sensation of incomplete evacuation were also common in these patients. The more of these symptoms that were present the more likely was it that the patient's pain or altered bowel habit, or both, was due to IBS. We conclude that a careful history can increase diagnostic confidence and reduce the amount of investigation in many patients with chronic abdominal pain.