Parry Sally D, Stansfield Rosamund, Jelley Diana, Gregory Wendy, Phillips Elizabeth, Barton J Roger, Welfare Mark R
Northumbria Division, University of Newcastle Faculty of Medicine, North Tyneside Hospital, North Shields, United Kingdom.
Am J Gastroenterol. 2003 Sep;98(9):1970-5. doi: 10.1111/j.1572-0241.2003.07664.x.
Irritable bowel syndrome (IBS) might develop after gastroenteritis. Most previous studies of this relationship have been uncontrolled, and little is known regarding other functional gastrointestinal disorders (FGIDs) after gastroenteritis. The primary aim of this study was to determine the frequency of IBS, functional dyspepsia, or functional diarrhea 6 months after bacterial gastroenteritis.
This was a prospective, community-based, case-control study. Cases had proven bacterial gastroenteritis, and controls were community-based. FGIDs were diagnosed with the use of self-completed Rome II modular questionnaires administered at baseline, 3, and 6 months. Subjects with prior FGIDs were excluded. The primary endpoint was the presence of one of the three specific FGIDs at 6 months.
A total of 500 cases and 705 controls were identified. Of the 500 cases, 265 (53%) consented, but only 128 cases and 219 community controls who consented were eligible. At 6 months, 108 cases and 206 controls returned the questionnaire. FGIDs were diagnosed in significantly more cases (n = 27, 25%) than controls (n = 6, 2.9%) (OR = 11.11, 95% CI = 4.42-27.92). IBS was diagnosed in 18 cases (16.7%) and four controls (1.9%) (OR = 10.1, 95% CI = 3.32-30.69); functional diarrhea in six cases (5.6%) and no controls. Functional dyspepsia was uncommon in both cases and controls. Similar findings were found at 3 months, with 29% of cases and 2.9% of controls having an FGID.
Symptoms consistent with IBS and functional diarrhea occur more frequently in people after bacterial gastroenteritis compared with controls, even after careful exclusion of people with pre-existing FGIDs. The frequency is similar at 3 and 6 months. Our findings support the existence of postinfectious IBS and give an accurate estimate of its frequency.
肠易激综合征（IBS）可能在肠胃炎后发生。此前关于这种关系的大多数研究都未设对照，对于肠胃炎后其他功能性胃肠疾病（FGID）了解甚少。本研究的主要目的是确定细菌性肠胃炎6个月后肠易激综合征、功能性消化不良或功能性腹泻的发生率。
这是一项基于社区的前瞻性病例对照研究。病例为确诊的细菌性肠胃炎患者，对照来自社区。使用在基线、3个月和6个月时自行填写的罗马II型模块化问卷来诊断FGID。排除既往有FGID的受试者。主要终点是6个月时出现三种特定FGID中的一种。
共确定了500例病例和705名对照。500例病例中，265例（53%）同意参与，但只有128例同意的病例和219名社区对照符合条件。6个月时，108例病例和206名对照返回了问卷。诊断为FGID的病例（n = 27，25%）明显多于对照（n = 6，2.9%）（比值比=11.11，95%置信区间=4.42 - 27.92）。诊断为肠易激综合征的病例有18例（16.7%），对照有4例（1.9%）（比值比=10.1，95%置信区间=3.32 - 30.69）；诊断为功能性腹泻的病例有6例（5.6%），对照无。功能性消化不良在病例和对照中均不常见。在3个月时也发现了类似结果，29%的病例和2.9%的对照患有FGID。
与对照相比，细菌性肠胃炎患者中出现与肠易激综合征和功能性腹泻相符症状的频率更高，即使在仔细排除既往有FGID的患者后也是如此。3个月和6个月时的频率相似。我们的研究结果支持感染后肠易激综合征的存在，并准确估计了其发生率。
