IMPACT OF FUNCTIONAL BOWEL DISEASE IN THE ELDERLY

大多数关于肠道疾病的数据涉及年轻人， 关于老龄化对老年人的影响， 胃肠道症状和病理生理学。 此外， 结肠疾病对功能状态和健康的影响主要是 未开发的 慢性特发性便秘与慢性腹痛 在没有器质性疾病的情况下与异常排便习惯相关 肠易激综合征（irritable bowel syndrome，IBS）是常见而重要的功能性肠 社区的疾病。 这些疾病的发病机制尚不清楚， 尽管它们可能伴有明显的病理生理学改变， 异常 本提案的总体目标是确定 慢性胃肠道症状（包括便秘， 腹泻和大便失禁）和功能性肠病， 探讨老年人抑郁症的发病机制及对生活质量的影响 功能性肠病 具体而言，我们的目标是评估 个别胃肠道症状，以及特定的功能 综合征在一个社区，使用经过验证的问卷。 这一阶段将 还探讨心理社会因素是否影响哪些老年人 有症状的医生（和不），以及是否某些 健康习惯（吸烟、饮酒、止痛药）或药物（包括 泻药或灌肠剂）起作用。 根据这些信息，我们将 确定具有特征明确的症状群的亚群（慢性 无痛性便秘，便秘型IBS，肠易激综合征 IBS）。 在这些子组中，我们将测试以下假设， 单独或组合与发病机制相关：a）饮食 因素（包括纤维）和整体营养和B）结肠功能障碍 如通过改变的口服营养转运和B）结肠 通过改变口服摄入标记物的转运所反映的功能障碍， 在随机抽取的慢性便秘和结肠炎患者中， 过境，一个新的地理评估。 我们还将检验假设 心理困扰（包括抑郁症），缺乏社会支持 和不良的应对策略对症状严重程度产生负面影响， 功能状态 互动将促进这些方法 马约的罗切斯特流行病学项目和生理学之间的联系 胃肠病学研究单位的专业知识。 这项建议应有助于 阐明这些重要的，高度病态的 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.