IMPACT OF FUNCTIONAL BOWEL DISEASE IN THE ELDERLY

大多数关于肠道疾病的数据都与年轻人有关，而且 关于衰老对健康的影响的信息很少。 胃肠道症状和病理生理学。而且，它的效果是 结肠功能状态和幸福感障碍在很大程度上 未被开发的。慢性特发性便秘和慢性腹痛 与无器质性疾病的异常排便习惯有关 (肠易激综合征[IBS])是常见且重要的功能性肠道 社区中的疾病。这些疾病的发病机制尚不清楚， 尽管它们可能伴随着明显的病理生理学 异常现象。这项提案的总体目标是确定 慢性胃肠道症状(包括便秘、 腹泻、大便失禁)和功能性肠病 并探讨其发病机制及对生活质量的影响。 功能性肠病。具体地说，我们的目标是评估 个别胃肠道症状，以及特殊的功能性 社区中的症状，使用经过验证的问卷。这一阶段将 还要解决心理社会因素是否会影响哪些老年人 出现在医生面前的症状(以及哪些不出现)，以及是否确定 健康习惯(吸烟、酒精、镇痛剂)或药物(包括 泻药或灌肠)起了一定作用。根据这些信息，我们将随后 识别具有良好特征的症状群的亚群(慢性 无痛性便秘，便秘为主，IBS为主，腹泻为主 IBS)。在这些分组中，我们将检验以下假设， 单独或联合与发病有关：a)饮食 因素(包括纤维)和总体营养以及b)结肠功能障碍 反映在口服营养和b)结肠运输的改变上 功能障碍反映在口服摄入的标志物的转运改变上， 在随机抽样的慢性便秘和结肠延长患者中 TRANSPORT，一种新的放射性评估。我们还将检验这一假设 心理困扰(包括抑郁)、缺乏社会支持 不良应对策略对症状严重程度和 功能状态。这些方法将通过互动来促进 在梅奥的罗切斯特流行病学计划和生理学之间 胃肠病研究组的专业知识。这项建议应该会有所帮助 阐明这些重要的、高度病态的疾病的起源和影响 老年人的状况。

Most of the data on diseases of the bowel concern younger individuals, and there is a paucity of information on the effects of aging on gastrointestinal symptoms and pathophysiology. Moreover, the effect of colonic disorders on functional status and well being is largely unexplored. Chronic idiopathic constipation and chronic abdominal pain associated with an abnormal bowel habit in the absence of organic disease (irritable bowel syndrome [IBS]) are common and important functional bowel diseases in the community. The pathogenesis of these disorders is unknown, although they may be accompanied by demonstrable pathophysiological abnormalities. The overall goals of this proposal are to determine the prevalence of chronic gastrointestinal symptoms (including constipation, diarrhea, and fecal incontinence) and functional bowel disease in the elderly, and to explore the pathogenesis and impact on quality of life of functional bowel disease. Specifically, we aim to assess the prevalence of individual gastrointestinal symptoms, as well as particular functional syndromes in a community, using a validated questionnaire. This phase will also address whether psychosocial factors influence which elderly persons with symptoms present to physicians (and which do not), and whether certain health habits (smoking, alcohol, analgesics) or medications (including laxatives or enemas) play a role. Based on this information, we will then identify subpopulations with well-characterized symptom clusters (chronic painless constipation, constipation-predominant IBS, diarrhea-predominant IBS). In these subgroups, we will test the hypotheses that the following, alone or in combination, are of relevance to pathogenesis: a) dietary factors (including fiber) and overall nutrition and b) colonic dysfunction as reflected by altered transit of orally nutrition and b) colonic dysfunction as reflected by altered transit of orally ingested markers and, in a random sample of those with chronic constipation and prolonged colonic transit, a new scintigraphic assessment. We will also test the hypothesis that psychological distress (including depression), lack of social support and poor coping strategies impact negatively on symptom severity and functional status. These approaches will be facilitated by interaction between Mayo's Rochester Epidemiology Project and the physiological expertise of the Gastroenterology Research Unit. This proposal should help elucidate the genesis and impact of these important, highly morbid conditions in the elderly.