Impact of coexisting irritable bowel syndrome on symptoms and pathophysiological mechanisms in functional dyspepsia
Impact of coexisting irritable bowel syndrome on symptoms and pathophysiological mechanisms in functional dyspepsia
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DOI：
10.1111/j.1572-0241.2004.30040.x
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发表时间：
2004-06-01
影响因子：
9.8
通讯作者：
Tack, J
中科院分区：
文献类型：
--
作者：
Corsetti, M;Caenepeel, P;Tack, J
流行病学研究表明功能性消化不良（FD）和肠易激综合征（IBS）之间有相当大的重叠。目的：本研究的目的是调查并发IBS是否也与FD的症状模式或病理生理有关。方法：对309例连续FD患者（207名女性，年龄42 +/- 0.8岁）进行问卷调查，评估消化不良症状模式和肠易激综合征的Rome 11标准。将8种消化不良症状的严重程度评分（0- 3,0 =无，3 =严重）相加计算总体症状严重程度。所有患者都进行了幽门螺杆菌检测，胃压力调节器检测胃膨胀的敏感性和对食物的适应性，以及胃排空呼吸试验。结果：54%的患者单独患有FD，而46%的患者患有FD + IBS。FD + IBS患者更有可能是女性（75% vs 60%, p < 0.01），体重减轻更大（5.4 +/- 0.6 vs 3.5 +/- 0.4 kg, p < 0.05）。同时存在IBS并不会增加出现任何消化不良症状的风险，但FD + IBS的总体症状严重程度明显更高（12.4 +/- 0.4 vs 9.8 +/- 0.3, p < 0.01）。FD + IBS患者的第一感觉阈值较低（2.9 +/- 0.3 Vs 3.8 +/- 0.3 mmHg, p < 0.05），不适阈值较低（7.9 +/- 0.4 Vs 9.5 +/- 0.5 mmHg, p < 0.05），胃胀超敏的患病率较高（44% Vs 28%, p < 0.05）。胃排空、适应进餐和幽门螺杆菌感染的患病率在两组中没有差异。结论：约一半FD患者符合IBS的Rome 11标准。FD + IBS在女性患者中更为普遍，并且与体重减轻程度较高、总体症状严重程度较高以及对腹胀过敏相关。
Epidemiological studies suggest considerable overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS).AIM: The aim of the present study was to investigate whether coexisting IBS is also associated with symptom pattern or pathophysiology in FD.METHODS: In 309 consecutive FD patients (207 women, age 42 +/- 0.8 yr), questionnaires were used to assess the dyspepsia symptom pattern and the Rome 11 criteria for IBS. The overall symptom severity was calculated adding the severity score (0-3, 0 = absent, 3 = severe) of eight dyspepsia symptoms. All patients underwent Helicobacter pylori testing, gastric barostat to determine sensitivity to distention and accommodation to a meal, and gastric emptying breath test.RESULTS: Fifty-four percent of the patients had FD alone, whereas 46% had FD + IBS. FD + IBS patients were more likely to be female (75% vs 60%, p < 0.01) and to have a greater weight loss (5.4 +/- 0.6 vs 3.5 +/- 0.4 kg, p < 0.05). Coexisting IBS did not increase the risk of having any of the dyspeptic symptoms but the overall symptom severity was significantly higher in FD + IBS (12.4 +/- 0.4 vs 9.8 +/- 0.3, p < 0.01). FD + IBS patients had a lower threshold for first perception (2.9 +/- 0.3 Vs 3.8 +/- 0.3 mmHg, p < 0.05) and for discomfort (7.9 +/- 0.4 vs 9.5 +/- 0.5 mmHg, p < 0.05) and a greater prevalence of hypersensitivity to gastric distention (44% vs 28%, p < 0.05). Gastric emptying, accommodation to a meal, and prevalence of H. pylori infection did not differ in the two groups.CONCLUSION: About half of the FD patients fulfill the Rome 11 criteria for IBS. FD + IBS is more prevalent in female patients and is associated with a higher weight loss, with greater overall symptom severity, and with hypersensitivity to distention.