A Community-Based, Controlled Study of the Epidemiology and Pathophysiology of Dyspepsia
A Community-Based, Controlled Study of the Epidemiology and Pathophysiology of Dyspepsia
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DOI：
10.1016/s1542-3565(04)00454-9
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发表时间：
2004-11-01
影响因子：
12.6
通讯作者：
Zinsmeister, Alan R.
中科院分区：
文献类型：
--
作者：
Castillo, Emma Janet;Camilleri, Michael;Zinsmeister, Alan R.
背景和目的：消化不良在临床实践和社区中很常见。社区消化不良患者的症状与膳食和病理生理的关系尚不清楚。本研究的目的是测量症状，人口统计学特征，胃运动和感觉功能与消化不良的社区。方法：修改后的肠道疾病问卷邮寄给随机抽样的奥姆斯特德县，明尼苏达州，居民。在社区受访者中确定的消化不良患者和健康对照完成了进一步的问卷调查，幽门螺杆菌血清学，胃排空造影，胃适应性Tc-99 m-单光子发射计算机断层扫描成像，和餐后症状和饱腹感的营养饮料测试。结果如下：共有34.1%的社区受访者在过去一年内报告消化不良，17.5%的人经常（过去一年中至少有25%的时间），18.4%的人报告与膳食有关的消化不良。10.8%的受访者经常出现消化不良，且与进餐有关。与非消化不良对照组相比，社区消化不良与较高的综合症状评分和饱餐后腹胀有关。社区消化不良还与较高的躯体化评分（P = .001）、其他躯体症状的报告（P = .07）和症状自评量表90的一般严重程度评分（P = .01）相关，但与运动或感觉功能障碍无关。胃容量，胃排空，最大耐受量之间没有显着差异社区控制和消化不良患者。结论：膳食相关性消化不良是社区消化不良的重要组成部分。社区消化不良患者在饱餐后症状评分较高，与胃过敏一致。这与较高的躯体化评分有关，而不是与胃排空或胃容量障碍有关。
Background & Aims: Dyspepsia is common in clinical practice and in the community. The relationship of the symptoms to meals and the pathophysiology in community dyspeptic patients is unclear. The purpose of this study was to measure symptoms, demographic features, and gastric motor and sensory functions associated with dyspepsia in the community. Methods: A Modified Bowel Disease Questionnaire was mailed to a random sample of Olmsted County, MN, residents. Dyspeptic patients and healthy controls identified among community respondents completed further questionnaires, Helicobacter pylori serology, gastric emptying by scintigraphy, gastric accommodation by Tc-99m-single-photon emission computed tomography imaging, and postprandial symptoms and satiation by a nutrient drink test. Results: A total of 34.1% of community respondents reported dyspepsia within the past year, frequent (at least 25% of the time in the past year) in 17.5%, and 18.4% reported meal-related dyspepsia. Dyspepsia was frequent and related to meals in 10.8% of respondents. Compared with nondyspeptic controls, community dyspepsia was associated with higher aggregate symptom scores and bloating after a fully satiating meal. Community dyspepsia also was associated with higher somatization scores (P = .001), reporting of other somatic symptoms (P = .07), and general severity score on the symptom checklist 90 (P = .01), but not with disordered motor or sensory function. Gastric volumes, gastric emptying, and maximum tolerated volumes were not significantly different between community controls and dyspeptic patients. Conclusions: Meal-related dyspepsia is an important component of dyspepsia in the community. Community dyspeptic patients have higher symptom scores after a fully satiating meal, consistent with gastric hypersensitivity. This is associated with higher somatization scores rather than disorders of gastric emptying or volumes.